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SAMPSON ESTATES BLK 4 LT 7
arnpson Estates Block 4 Lot 7 x'051-811-12 MUNICIPALITY OF ANCHORAGE On -Site Water & Wastewater Program PO Box 196650 4700 Elmore Road Anchorage, Alaska 99519-6650 Phone: (907) 343-7904 Fax: (907) 343-7997 http://www.muni.org/onsite On -Site Wastewater Disposal System Permit Permit Number: OSP211434 Work Type: Septic Upgrade Tax Code Number: 05181112000 Site Legal Address: SAMPSON ESTATES BLK 4 LT 7 G:1560 Site Mailing Address: 22649 GABRIEL CIR, ADU, Chugiak Owner: SPENCER DENNIS L & STEPHANIE L Design Engineer: C&M ENGINEERING SERVICES This permit is for the construction of: Effective Date Expiration Date: 1»enr •c U Inc, f v Departinent Lot Size in Sq Ft: Total Bedrooms: 5/13/2022 5/13/2023 40215 Q Disposal Field Q Septic Tank ❑ Holding Tank ❑ Privy ❑ Private Well ❑ Water Storage All construction shall be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80) 3. The wastewater code requires inspections during the installation. The engineer shall notify the Development Services Department per AMC 15.65. Provide notification by calling (907) 343-7904 (24/7). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather shall be either: a. Opened and Closed on the same day, or b. Covered, sealed, and heated to prevent freezing Special Provisions: • A test hole is required prior to construction of the absorption field to confirm minimum separation to impermeable soil and seasonal high groundwater, as well as percolation rate. Construction may proceed at your own risk prior to 7 -day groundwater monitoring. If results require a design change, construction shall stop pending approval of a change order. Please submit results with the inspection report (or change order, if required). • The reserve site for the new design is the proposed initial Pannone Engineering field. Received By: Issued By: 9ny1nee! CAnd O��S�gn G�lrnr�c�, Date: Date: 22 2 MUNICIPALITY OF ANCHORAGE Community Development Department i2 Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program ON-SITE SEWERIWELL PERMIT APPLICATION Parcel I.D. 051-811-12 Property owner(s) Dennis & Stephanie Spencer Day phone Mailing address 22651 Gabriel Circle Chugiak,AK Site address Same Legal description (Sub'd., Block & Lot) Sampson Est 134 L7 Legal description (Township, Range & Section) Lot Size 40,215 Sq. Ft. Number of Bedrooms 2 APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (® all that apply) Absorption Field X❑ Initial ❑ Single Family (SF) X❑ Septic Tank X❑ Upgrade 0 (w/wo ADU) Holding Tank El Renewal Renewal ❑ (D) ❑ Privy ❑ Multiple Dwellings ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees:Waiver Fees: Date of Payment: /0 01-z I Date of Payment: Receipt Number: © 102-5 G Receipt Number: Permit No. 0-510211 (4 3 9. Waiver No. Permit App__- : , _.,:c Municipality of e Anchorsg P.O. Box 196650 • 4700 Elmore Road Anchorage, Alaska 99519-6650 • (907) 343-7904 a Fax (907) 343-7997 http://www.muni.org/Onsite Development Services Division On -Site Water and Wastewater Program * * * * VARIANCE/WAIVER REVIEW * * * * Waiver#: OSV221055 COSA#: Permit#:OSP221434 PID#: 051-811-12 Legal Description: SAMPSON ESTATES BLK 4 LT 7 Engineer: CM Engineering Your request for a waiver to place the trench perpendicular to the contours has been approved. This waiver approval applies to the proposed trench only. Any future upgrade to the on-site wastewater disposal system will require that all code requirements be met. ............................................... ■ ............................. ■ 1 Waiver is Granted: X Waiver is not Granted: Date: g ?j ( ZZ Approved by: 44 Name of Review **** VARIAN C E/WAIVER REVIEW **** Ph: 907-854-5558 Municipality of Anchorage Onsite Water & Wastewater Program 4700 Elmore Rd Anchorage, Ak 99507 RE: Proposed Septic System Upgrade for SAMPSON EST BLOCK 4 LOT 7 Dear Reviewer, We were approached by the owner to change the previously permitted design at the subject property. Instead of the permitted design, we are proposing to install a gravity fed trench near the existing system that serves the main house. • The system will be sized for 2 -bedrooms. • The previously permitted system will serve as the reserve site. • The area has been regraded to the slopes shown on the plans. • A testhole was excavated for groundwater verification to a depth of 12 -feet and remained dry in June. The testhole will be deepened to 14 -feet and groundwater monitored as required and a percolation test will be constructed. • The Constructing engineer's testhole 1 serves as the basis for soil rating. Portions of the system will be in a layer which has a fast 2 -minute per inch perc rate, and portions of the system will be in areas with 10 and 25 minute per inch peres. A 0.6 application rate is conservative for this system and is justified based on the many perc tests that have been performed on this property. • The new leachfield will be in the section line easement. • Both of the old existing septic systems on the lot have reportedly been removed/ filled with sand. If encountered the portions within 2x the leachfield effective depth will be removed and filled with sand. • The drainfield will be installed cross slope. We have provided a profile drawing and requesting that the requirement for the drainfield to be installed parallel to the contours be waived. The waiver is justified because the entire system will fit within the accepting strata. The installation of the proposed system will not adversely impact adjacent lots. Thank you for your time in reviewing this permit request. Please do not hesitate to contact me at 907-854- 5558 or by email cgbalzarini(cDgmail.com with any questions or concerns. Sincerely, Charles Balzarini, PE 7/28/22 x� t "CHARLES G BALZARINI' CE13854��.o ���t�_ PR0FES'SI��A -�''� C&M ENGINEERING SERVICES 907-854-5558 Septic Design Calculations Residence: SAMPSON ESTATES BLOCK 4 LOT 7 number of bedrooms 2 br Water usage/bedroom 150 gpd/br Water Usage 300 gpd - U11VICiVJiVIVJ tUK KtttKt1MLt U1VLY. Ott PLAINS 1 -UK U1MEN51IUN5 TO BE USED IN CONSTRUCTION" Calc By: CGB Date: 7/22/2022 ,dmr a "CHARLES G BAI ZARINI' CE13854AMW � �>�—PROFESSO -mP NOTE: INSTALL ALL COMPONENTS IN ACCORDANCE WITH MUNICIPAL CODE AND MANUFACTURER'S RECOMMENDATIONS. OWNER TO ORDER AN ASBUILT SURVEY UPON COMPLETION OF THE WORK POSSIBLE LOCATION OF OLD LEACHFIELD. THIS FIELD WAS SUPPOSED TO BE REMOVED AND FILLED WITH MOA SAND WHEN THE NEW SYSTEM FOR THE 4 BR HOME WAS INSTALLED. IF ANY PORTION OF THE EXISTING FIELD IS ENCOUNTERED, IT SHOULD BE REPLACED 1 WITH MOA SAND. \ WE SAMPSON �� RA ESTATES BLOCK 4 LOT 7 DRIVEWAY 4 BR HOUSE 0 J 1 -- FENCE I I i 11, 2 BR ADU T 'PROX LOCATION OF OLD BED SYSTEM SEPARATION DISTANCE NOTES: / THE PROPOSED SEPTIC SYSTEM IS GREATER THAN: 100' FROM THE ON—SITE WELL 100' FROM ANY NEIGHBORING WELLS 200' FROM ANY PUBLIC WELLS 100' FROM ANY SURFACE WATER 10' TO ANY PROPERTY LINE OR FOUNDATION i MAINTAIN 5' MIN FROM COVERED \ ENTRY POSTS v ..0 1 I 00 I M �*:49TM ••*ri J . CHARLES G BALZARIKI . rot �06, CE -13854 ..•�`��r AEW h>>,PROFESSI�NP r EXIST SYSTEM LEGEND MONITOR TUBE ® TEST HOLE 0.57.\ SLOPE INDICATOR 2022 TESTHOLE DRY TO 12' DEEPEN TO 14' AND PERC DURING CONSTRUCTION 5'x50'x4' EFF SHALLOW TRENCH 8' MAX EX DEPTH SEE PROFILE LEACHFIELD AREA HAS BEEN RE—GRADED o' I NEW 1000 GAL GREER POLY TANK WITH INSULATED MANWAY RISER AT FIRST COMP APPROX LOCATION OF CONSTRUCTION ENGINEER'S TESTHOLE I — PROPOSED TESTHOLE RESERVE SITE. REFER TO ORIGINAL APPROVED DESIGN " = 30' FOR DETAILS LEGAL DESCRIPTION: SAMPSON ESTATES BLOCK 4 LOT 7 C&M ENGINEERING SERVICES OWNER: SPENCER I DATE: 7/28/22 REV: DRAWN: 907-854-5558 SITE PLAN REF: PROVIDE J' COVER OVER FIELD SLOPE SIDES AT 4:1 MAX 2" INSULATION[ EXIST. GRADE F-3` / AT ¢% AVG ��, � | 8 V 1`-] \-'.� / `'° REQUIRED FEATURES LIKE CLEANOUT3'MON|TOR TUBES` FILTER FABRIC, ETC NOT SHOWN THIS VIEW. BOTTOM OF PIPE BOTTOM OF TRENCH 907-854-5558 LEGAL DESCRIP11ON: SAMPSON ESTATES BLOCK 4 LOT 7 Performed For: S��t r,� Date Performed. Legal Description: `J�V✓) (tea✓ t T -r 13 L4 L 7 Township, Range, Section: Depth 1-1 _ r 3- 4- 5- 6- 7- 8- 9- 10- 11- 12 13- 14- 15- 16- 17- 18- 19- 20- 7or50T/ ©p'c'A"�6 5� SAND �✓��>z�lc/c L �0' 1 Site Plan WAS GROUND WATER ENCOUNTERED? NO / s IF YES, AT WHAT DEPTH? L _ 0 Depth to Water After P Monitoring? /0 E Date: Reading Date Gross Time Net Time Depth to Water Net Drop NJ`i PFRC(lI ATION] BATF lminules/inchl PFRC HOLE DIAMETER TEST RUN BETWEEN ✓ FT AND FT COMMENTS 6 RQUA/(7 A /47L fz V��/�[Q!L ©p/J_y PERFORMED BY: ( _c � &2AF7'^lj-- I C` `/► 4 ZAJ2.'1At_T CERTIFY THAT THIS TEST WAP PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: j� Municipality of Anchorage aEt rrs ••'�9,�j Development Services Department On Water Wastewater Section gip'• i 4 TH *• 1 -Site and * ' 4700 Elmore SL �,• .... •••••• P.O. Box 196650 Anchorage, AK 99519-6650 • .........., www.muni.org/onsite 343-7904 "':"" CS alZMinl ; (W� ti 9�, • ~ (907) • ir C� do Soils Log - Percolation Test Performed For: S��t r,� Date Performed. Legal Description: `J�V✓) (tea✓ t T -r 13 L4 L 7 Township, Range, Section: Depth 1-1 _ r 3- 4- 5- 6- 7- 8- 9- 10- 11- 12 13- 14- 15- 16- 17- 18- 19- 20- 7or50T/ ©p'c'A"�6 5� SAND �✓��>z�lc/c L �0' 1 Site Plan WAS GROUND WATER ENCOUNTERED? NO / s IF YES, AT WHAT DEPTH? L _ 0 Depth to Water After P Monitoring? /0 E Date: Reading Date Gross Time Net Time Depth to Water Net Drop NJ`i PFRC(lI ATION] BATF lminules/inchl PFRC HOLE DIAMETER TEST RUN BETWEEN ✓ FT AND FT COMMENTS 6 RQUA/(7 A /47L fz V��/�[Q!L ©p/J_y PERFORMED BY: ( _c � &2AF7'^lj-- I C` `/► 4 ZAJ2.'1At_T CERTIFY THAT THIS TEST WAP PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: j� *1 0 � m N g = 0 rn Ti 0 m $ m � t w m oto ` z �' , • r- O o � w C j - co irl) (/ V co zaZ7 N(�oS o tom 2 o-vT �' oS Nzz zmnm°D ��� zmoz mM�oM 0 ,�*,� 25 o m � 0 ;ut'�n A M ;a rn Z ov o cm's W zc�oo-r o co C5 �Ozrmnc�mox Or+i �-- �; o� rn m -to cn in m C) ooaQ= ms.Oc m 6�0 o f to CZ Z5a IE zo zom -m oo ID z - rn �b Q ov m co e • • m • N • • 'T} o Ncoo �e♦ ♦ U •b N . � e ♦ Q Lp1 pr ♦ �. d _ C7 mt_ OQ;A 0 m 0 .0.9 .0.9£ o•z� 0 h? Ln II w 0 0 0 0 a M OD w 0 POST IN A CONSPICUOUS PLACE tri n t ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working atV days in advance for final inspeciton. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate)v number.' U� 'Y `l1'Ct21ti'llf '* MUNICIPALITY OF ANCHORAGE - RIGHT OF WAY DIVISION 1 ` 4700 ELMORE ROAD TELEPHONE (907) 343-8240 EMAIL: moarowrequests@muni.org RIGHT OF WAY PERMIT R222083 Type: General Status: Issued Grid: NW1560 Date Applied: 08/26/2022 Date Issued: 08/26/2022 Issued By: PWMSW Construction Start Date: Last Updated: 08/29/2022 Last Updated By: PWMSW Permittee: Guaranteed Services, LLC Work Order: Utility: Contact Person: Wayne DeVore, 907-830-8263 Primary Inspector: Jon Sauerbrey Address/Loc: 22651 GABRIEL CIR, Chugiak - @ Sampson Legal Description: SAMPSON ESTATES BILK 4 LT 7 G:1560 Original Work Replacement of septic System that was installed under R142460. Description: Property owner will update Encroachment permit after completion of the installation. Certificate of Liability Insurance valid until 5/25/23 Most Recent Summary � Work Area Location Method_..___ Road Closure From Easement ROW None 8/29/2022 7:00 AM Summarized Financial Transactions Fee Description Permit Quantity 1 Total Fees: To 9/9/2022 5:00 PM Amount $135.00 $135.00 See reverse for requirements/remarks. I have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this permit. Signature: Date: Municipality of Anchorage Community Development Department Page 1 of 3 On -Site Water and Wastewater Program 4700 Elmore St. • P.O. Box 196650 Anchorage, AK 99519-6650 • http://www.muni.org/onsite • (907) 343-7904 ON-SITE WASTEWATER INSPECTION REPORT Permit Number: OSP141372 PID Number: 051-811-12 ❑ New ✓❑ Upgrade Name: Ron Robinette ABSORPTION FIELD 2] Deep Trench ❑ Shallow Trench ❑ Bed ❑ Mound Address 22651 Gabriel Circle Chugiak, AK 99567 ❑ Other Phone Number of Bedrooms Soil Rating Total depth from original grade 4 6GPDISF 9 Ft. LEGAL DESCRIPTION Depth to pipe invert from original grade 3 Ft. Gravel depth beneath pipe 6Ft. Subdivision Block Lot Sampson Estates 4 7 Fill added above original grade 3-4 Ft. Gravel length 92 Ft. Township Range Section Gravel width 3FL Beds: Number of Lines Distance between lines Ft. SEPARATION DISTANCES To Septic Absorption Lift Station Holding Sewer Total absorption area Number of trenches Dist. between trenches From Tank Field Tank Line 1,104 Ft TWO > 12 Ft. well >100' >100' N/A N/A >25' TANK ❑ Septic ❑ S.T.E.P. ❑ Holding ❑ Other Manufacturer Anchorage Tank Capacity 1,25OGa1, Surface water >100' >100' N/A N/A Material Number of compartments Lot Line >5' >10' N/A N/A Steel Two NA Foundation >5' >10' N/A NIA LIFT STATION Manufacturer Capacity Curtain Drain None Noted Gal. Remarks Existing Septic Tank and Lift Station Pump on level at in. Pump off level at in. High water alarm at in. Decommissioned in Accordance with Municipal Code. Existing Absorption Bed Abandoned in Place. Pump make and model Electrical Inspections performed by Installer PIPEMATERIAL Housetotank D3034 Tankto drainfield D3034 G&R Excavating Drainfield F810 CO/MT D3034 Inspector W Roberts BENCH MARK (Assumed elevation) 100 -Oft Inspection .t dates: f 10/3/14 p a 10!6/14 Location and description 3" 10/6/14 4'" Back Deck Northeast Corner. COMMUNITY DEVELOPMENT DEPARTMENT APPROVAL �• ........... se Conditional Approval: �j`P'•• S,I� Date i� 49TH �1 ........... ....... MICHAEL E. ANDERSON s. GE -4381 : _� Approved (` ZX1-- Date Jr f t41, ' —= l r0 � inspection Keport_ I - Inca e �/ I CD mo0 mI C F- m C) m IN06RSON 6NClNP6fllNC I O o� r ? o m �J N n I 00 C R1 N l .60 N Ow I � 9e� I O �C'i WII Ili mo 0 o I \ T > 3 I O o Dr ou HM O o �i° ' \ r I W 0 F O I O u �m m � \ I cm-� o ° O \\ 1 0 0 0m m2. \ 1 Z 0 n Z o \ I rri f \\ I r m�m� co < r \ x m L4 Ana > o D "' o' 11 mss, Cl) p o p o CI 3 fD F (n A y .pr^ N CD I � V ! r K C/") N( N W. A N N \ I W N N V f0 O IT O D \ fIJ W V 4J + O W A \ I T W OY m EO m m W W \ �' ,••' a ' .p °•.�A j. o tOR on o O Q £ •L� io f f • w o i / o m 00AV o s 1 Z eA do • . Z i .. - Q (P N O N Municipality of Anchorage Page 3 of 3 DEVEOPMENT SERVICES DEPARTMENT 4700 South Bragaw Street Anchorage, AK. 99519-6655 - 343-7904 On -Site Wastewater Disposal System or Well Inspection Report Permit Number: OSP141371 x Lo H PID No. 051-811-12 v U 46'(Trench Length) 92.3 46' (Trench Length) PROFILE AS -BUILT No Scale 92.0 On -Site Wastewater Disposal System Permit MUNICIPALITY OF ANCHORAGE Development Services Department On -Site Water & Wastewater Program 4700 Elmore Road, PO Box 196650 Anchorage, AK 99519-6650 Telephone: (907) 343-7904 Permit Number: OSP141372 Tax Code Number: 05181112000 Work Type: Septic Upgrade Permit Effective Dates: October 03, 2014 to October 03, 2015 Design Engineer: ANDERSON ENGINEERING Subdivision: SAMPSON ESTATES Site Legal Address: SAMPSON ESTATES BILK 4 LT 7 G:1560 Owner/Address: ROBINETTE RONALD JR & SHANNON 22651 GABRIEL CIRCLE CHUGIAK AK 995675506 Site Mailing Address: 22651 GABRIEL CIR, Chugiak This permit is for the construction of: Lot Size in Sq Ft: Total Bedrooms: �: 1 40215 4 Y Disposal Field Y Septic Tank N Holding Tank N Privy N Private Well N Water Storage 3e^, All construction must be in accordance with: 1. The attached approved design. 2. All requirements specified in Anchorage Municipal code Chapters 15.55 and 15.65 and the State of Alaska Wastewater Disposal Regulations (18AAC72) and Drinking Water Regulations (18AAC80). 3. The wastewater code requires inspections during the installation. The engineer must notify the Development Services Department at least 2 hours prior to each inspection. Provide notification by calling (907) 343-7904 (24 hours). 4. From October 15 to April 15, a subsurface soil absorption system under construction during freezing weather must either: A. Open and Close on the same day. B. Covered, sealed, and heated to prevent freezing. Special Provisions: Jack Frost verbally approved the encroachment nonobjection on 10/3/14. /11l1Vq -vo 5h&cd /,vnere fAe o(d 5 -('e -Id &/,,5 io aktt how r`f Received Issued By By: Date: r I q Date: �d MUNICIPALITY OF ANCHORAGE Community Development Department Phone: 907-343-7904 Development Services Division Fax: 907-343-7997 On -Site Water & Wastewater Program Parcel I.D. ON-SITE SEWERIWELL PERMIT APPLICATION 051-811-12 Property owner(s) Ronald & Shannon Robinette Day phone Mailing address 22651 Gabriel Circle Chugiak, AK 99567 Site address Same Legal description (Sub'd., Block & Lot) Sampson Estates, Block 4, Lot 7 Legal description (Township, Range & Section) Lot Size 40,215 Sq. Ft. Number of Bedrooms Four (4) APPLICATION IS FOR: APPLICATION IS AN: TYPE OF DWELLING: (M all that apply) Absorption Field ❑X Initial ❑ Single Family (SF) ❑X (w/wo ADU) Septic Tank ❑X Upgrade Duplex (D) F-1Holding Tank ❑ Renewal ❑ Multiple Dwellings ❑ Privy ❑ (SF and/or D) Private Well ❑ Water Storage ❑ THIS APPLICATION INCLUDES A VARIANCE / WAIVER REQUEST FOR: Distance: I certify that the above information is correct. I further certify that this is in accordance with applicable Municipal Codes. (Signature of property owner or authorized agent) Permit/Rush Fees: 551 Date of Payment: ClI3I N Receipt Number: 0(ob3bG Permit No. 0'591'A 1312 Permit App__ :L.:c. Waiver Fees: Date of Payment: Receipt Number: Waiver No. ANDERSON ENGINEERING P.O. BOX 240773 ANCHORAGE, AK 99524 522-7773 677-7766 (FAX) August 30, 2014 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program 4700 South Bragaw Street Anchorage, AK 99519-6650 Subject: Lot 7, Block 4, Sampson Estates Subdivision Septic System Design and Permit Application Impacts to Adjacent Properties Dear Onsite Services Engineer: The existing septic system on Lot 7, Block 4, Sampson Estates Subdivision is in a state of failure and must be replaced prior to the issuance of a Certificate of On Site System Approval (COSA). We are therefore requesting a permit be issued for the upgrade of the septic system to accommodate the four-bedroom home on the lot. The attached Site Plan and backup documentation identify the location and configuration of the upgrade to the proposed septic system. The existing septic tank and lift station will be decommissioned in accordance with Municipal Code. The existing absorption bed will be abandoned in place. A new 1,250 gallon septic tank will be placed at the same location as the existing tank. Also identified on the plans are. the locations of the existing well. No conflicts exist between the existing septic system and the wells and septic systems on adjacent lots. Drainage arrows are shown indicating the current drainage patterns. The drainage patterns will be maintained after construction. The test hole placed on the lot indicated silty gravel with some sand (GM). The application rate was determined to be .6 gallons per day per square foot based on a percolation rate of 20 minutes per inch. We are proposing to construct 2-42' long by 3' wide absorption trenches with 6' of gravel beneath the distribution pipe. The distribution pipe in the trench will be placed at 3' below the surface with the total depth at 9'. No groundwater was encountered during placement of the original test hole and none has been noted since. The absorption trenches will be placed in the 33' section line easement at the north end of the lot. No development exists to the north of the lot line and the easement will not be developed for any access in the future. All lots in the subdivision are developed and Lot 7, Block 4, Sampson Estates Subdivision August 30, 2014 Page Two accessed from the existing road system. The ground surface on the lot slopes slightly to the north at grades approaching 2%. The trenches will be constructed parallel to the contours of the ground as much as possible and in conformance with design criteria. A minimum of 10' will be maintained between all components of the septic system and the existing water service and 100' from any surface water and wells in the area. If the system is constructed in accordance with our design the following statements apply: 1. The system, if constructed as designed, will have no adverse impact on the wells in the area or those to be constructed in the future. 2. The system, if constructed as designed, will have no adverse impact on existing septic systems in the area or those to be constructed in the future. 3. The system, if constructed as designed, will have no adverse impact on reserve space, either surface or subsurface, on any lots located in the area. 4. The system, if constructed as designed, will have no adverse impact on drainage patterns in the area. The current drainage pattern will be maintained. Sincerely, Michael E. Anderson, P.E. Attachments st MICHAEL E. ANDERSON No. CE -4381 v 'e -A , CA -A w d o Q \� a`o p v i �V) U c ° m v � „ \ w0°o-o`a� \ Uj Hw o o o o Cr E C o I\ N ✓ j ED > C N vDo =V c° a2 E co p ¢ ow w mim \\ C� ommo°o avoOOE y �:aJS0oN�3 a,o °0 Oo�J1LLLJJJ1 ��� :�VI I LJ I \\ a3or«g;Ul I N �--------- ' ^ E I C 020 sym \ \ OrSo w \\ \\ O I / u30 \ 00 m N \ \\ oa \\ N J roc \ m8v° \ 3 zol I � Z`n 1 q o° \ \\ Q sz � Ind w\\LL mJ Q hU VI \ 02 / \ 0 o 3 I xs \509" 'ILI1 I 00 ova ALL N x ¢ u \ /a �1 era�rtmn xmuexr / -SF'' w o: • LOT 7, BLOCK 4, SAMPSON ESTATES SUBDIVISION DESIGN FACTORS: SYSTEM REQUIREMENTS Four Bedroom House Deep Trench System Pere. Rate: 20 Min./Inch 1,250 Gallon Septic Tank Application Rate: .6 GPD/SF 6' Drainfield Rock 4 Bedrooms X 150 GPD/.6 GPD/SF (Application Rate) = 1,000 SF Absorption Area 1,000 SF/12 SF/ LF = 83.33 LF Trench Length THEREFORE: Construct 2-42' Long x 3' Wide x 6' Effective Depth Absorption Trenches at the Location Shown. Distribution Line to be Placed at 3' Below the Existing Surface. Total Depth to be 9' Below the Surface. Decommission Existing Septic Tank and Lift Station in Accordance with Municipal Code. Place Flow Splitter Valve to Insure Even Flow to Each Trench. Abandon Existing Absorption Bed in Place. Provide 4' of Cover Over Septic Tank and 3' of Cover Over Absorption Trenches.. Natural Backfill 2'6" Geotextile Fabric 6" 4" Perforated PVC (Holes Down) 6'0" I �— Drainfield Rock 5' TYPICAL DEEP TRENCH SECTIOP' (NO SCALE) NOTE: Grade Area Over Trench to Drain Away. Minimum 6' Separation From Bedrock. Minimum 4' Separation From Groundwater. Minimum 100' Separation From Wells in the Area. Minimum 100' Separation From Surface Water or Streams: MUNICIPALITY OF ANCHORAGE DEVELOPMENT SERVICES DEPARTMENT 4700 BRAGAW STREET ANCHORAGE, AK 99519-6650 SOILS LOG - PERCOLATION TEST LEGAL DESCRIPTION: SAMPSON ESTATES BLOCK 4 LOT 7 PERFORMED FOR: RON ROBINETTE DATE: 7/21/2014 PROJECT No.: PARCEL ID#: TECHNICIAN: JB DEPTH TEST HOLE # 1 0w) OB/OG 1 2 3 4 5 6 7 GM 8 9 10 I1 12 13 14 B.O.H. @15' 16 17 18 19 SLOPE z WAS GROUNDWATER ENCOUNTERED? No IF YES a WHAT DEPTH DEPTH OF WATER AFTER MO DATE OF MO SITE PLAN SEE SITE PLAN N I OR rNG NONE NITORMG: 8/I/2014 � SEE SITE PLAN DATE READING GROSS TIME NET TIME WgTER O NET DROP (MINUTES) (MINUTES) (INCHES) (INCHES) 7/21/14 TEST HOLE PRESOAKED PRIOR TO TESTING: 1 2:50 7.50" 2 3:20 30 9.00" 1.50" 3 3:21 7.25" 4 3:51 30 8.75" 1.50" 5 3:52 7.50" 6 4:22 30 9.00" 1.50" PERCOLATION RATE: 20 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 5 FT. and 6 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. - TEST PERFORMED BY ANDERSON ENGINEERING TECHNICIANS, I, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/30/14 PERCOLATION RATE: 20 (MIN/INCH) PERC. HOLE DIA. 6 (INCHES) TEST RUN BETWEEN: 5 FT. and 6 FT. COMMENTS: TEST HOLE PRE SOAKED PRIOR TO TEST. - TEST PERFORMED BY ANDERSON ENGINEERING TECHNICIANS, I, MICHAEL E. ANDERSON CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPLE GUIDELINES IN EFFECT ON THIS DATE: 8/30/14 POST IN A CONSPICUOUS PLACE ALL WORK MUST BE INSPECTED Field Inspection Request required 2 working days in advance of starting work and 2 working days in advance for final inspection. Call (907) 343-8206 (voice recorder) for scheduling. Permit is not valid without the call-in and also must include the one -call ticket (utility locate) number. MUNICIPALITY OF ANCHORAGE RIGHT OF WAY DIVISION 4700 ELMORE-ROAD. TELEPHONE(907) 343-8240 .'. ., Si*n-Ar�tlrncc• 7761 t�'A'F2RfGl :�('IR-.f`.E:l�r.7:,b +'�ri�'c�'.;..:..,:.�':ri Permit Summary iLtion :;:. QTY'' AMT See reverse for requirements/remarks. have read and understand both sides of this permit. I agree to the terms and conditions; and I certify that all work will comply with federal, state, and municipal codes and regulations and the provisions of this permit. Signature: ��'` �i�'f ^ Date: Municipality of Anchorage Page of DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Permit Number: t?QD 3 2`�, - PID Number: 05/— Name: Wastewater System: El New X Upgrade W/c-tr�M i-JOLL11`1G W 12TH Address: ABSORPTION FIELD F0 (0'709(09 0-HO61 y 5607 Phone: Lc81&- 1J10�r 5' No. of Bedrooms: 3 ❑ Deep Trench ❑ Shallow Trench 0 Bed ❑ Mound ❑ Other LEGAL DESCRIPTION Soil Rating: Total Depth from original grade: 700 S�/grz = a, i GPD/Sq. . Ft. /• o Lot: Block: Subdivision: Depth to pipe bottom from original grade: Gravel depth beneath pipe 7 4/ Swmpge✓ Er! 0,5 Ft. 0,S Ft. Township: Range: Section: Fill added above original grade: Gravel length: J Sr✓ / w 3 a. 5 Ft. 6-0 Ft. EX rr,,/ WELL: El New ❑ Upgrade Gravel depth: w,� rx Number of lines: '^' g° ` v Distance between lines: 6 a v Ft. FL Classification (Private, A,B,C): Total Depth: Cased To: Total absorption area: Pipe material: ✓9 %z-- / 'Ya Ft. Ft. SQ. Ft. AJ, m 303 / �Jv ° Driller: Date Drilled: Static Water Level: Installer: Date installed: Ft. 9F7 Xe Yield: Pump Set at: I Casing Height Above Ground: TANK GPM Ft. Ft. /E�X/t/ir✓ SSS - SEPARATION DISTANCES Xseptic ❑ Holding ❑ S.T.E.P. To Septic Absorption Lift Holding Public/Private Manufacturer: Capacity in gallons: From Tank Field Station Tank Sewer Lines f /X vd Material: Number of Compartments: Well t/o° /oo r /<S N/a $O' She/ 2 Surface LIFT STATION Water Water ^j� F,�.Jh�j 14&� Lot / i. r i t/U Size in gallons: Manufacturer: Line 3 y 33 Soo A o4. fir. 7_o^. Af "Pump on" level at: "Pump off" level at: High water alarm at: Foundation afr 67' 2jr 40,5- vys ss Curtain Pump Make S Model Electrical Inspections performed by: Drain Remarks: BENCH MARK Location and Description: u ever of G,eo� A /f Lr� Leese%f�/z/� Assumed Elevation: /3ed ex ,.✓64ce/ 6/Add.f/<�a/ w.�rz /oo, oU ENG'INEER'S/ SIAL 7b 77. /t/or r"/.. 1a .-_ �, a�Fc% AG.7-G/G %/YY✓ Lf rea , %w - .. .,._ 1:. vx J, � L p,Y'AFre./t T 6/e4..v. 1,r u)`// zed' Jo n/ruT check lel Leve pe �� �uWN GIEG NOH fJ F u+-� JNr�.CP. /°/s-�r� Inspections performed by: Dates: 1st ✓'' 2nd Department of Healt , nd Hum n, rvices approval Reviewed and approved by Date: 72-013 (1/91) MOA 25 Permit No. ga d 3 3 Page 2- of "),_ Municipality of Anchorage DEPARTMENT OF HEALTH AND HUMAN SERVICES ENVIRONMENTAL SERVICES DIVISION P.O. Box 196650 • Anchorage, Alaska 99519-6650 • Telephone: 343-4744 On -Site Wastewater Disposal System and/or Well Inspection Report Legal Description: Xc Af Ldy % /�/r y Din ni MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND HUMAN SERVICES P.O. BOX 196650, 825 "L" STREET, ROOM 502 ANCHORAGE, ALASKA 99519-6650 ON-SITE WASTEWATER DISPOSAL SYSTEM (UPGRADE) PERMI PAGE 1 OF 1 PERMIT NUMBER:SW920332 DATE ISSUED:10XIW-992- DESIGN ENGINEER:EAGLE RIVER ENGINEERING SERVICES EXPIRATION DATE:10/02/93 OWNER NAME:HOLLINGSWORTH WILLIAM L OWNER ADDRESS:22651 GABRIEL CIR CHUGIAK AK 99567 PARCEL ID:05181112 LEGAL DESCRIPTION: SAMPSON ESTATES BLK 4 LT 7 LOT SIZE: 40215 (SQ. FT.) NUMBER OF BEDROOMS: 3 THIS PERMIT: 3 THIS PERMIT IS FOR THE CONTRUCTION OF: DISPOSAL FIELD SYSTEM ALL CONSTRUCTION MUST BE IN ACCORDANCE WITH: 1. THE ATTACHED APPROVED DESIGN. 2. ALL REQUIREMENTS SPECIFIED IN ANCHORAGE MUNICIPAL CODE CHAPTERS 15.55 AND 15.65 AND THE STATE OF ALASKA WASTEWATER DISPOSAL REGULATIONS (18AAC72) AND DRINKING WATER REGULATIONS (18AAC80). 3. THE FOLLOWING SPECIAL PROVISIONS. SPECIAL PROVISIONS: ENGINEER MUST NOTIFY DHHS AT LEAST 2 HOURS PRIOR TO EACH INSPECTION. THIS PERMIT IS ISSUED FOR THE UPGRADE OF A BED SYSTEM THAT IS OUT OF LEVEL. WORK WILL BE PERFORMED AS OUTLINED IN THE 10/02/92 LETTER FROM ERES. n DATE: l0/US�%'2- RECEIVED BY: ISSUED BY: -kt`N &2177-1- DATE:��?UZZ AMSIQ RAWT EUSIlUMAU&I SeTWAkeo October 2, 1992 John Smith, P.E. Municipality of Anchorage Dept. of Health & Human Services 825 L Street Anchorage, AK 999502 Louis Butera, P.E. Registered Civil Engineer Re: Sampson Estates, Lot 7, Block 4 Dear Mr. Smith: 719 tiedfh���cF X �y4�ao hora S�rGge We have been designated by Mr. Hollingsworth, the above referenced property's owner, as the engineer in charge of any engineering designs and modifications, succeeding Constructing Engineers' responsibility to this matter. As per our letter of August 31, 1992, and subsequent telephone conversations, we are proposing that the existing bed be uncovered and the existing leachfield piping be leveled to alleviate your concerns with the leachfield piping as addressed in your letter of August 29, 1992. It is entirely possible that the cleanout located on the end of the manifold has separated, causing all the effluent to disperse at this point. This would explain both differential level readings and unequal effluent dispersion. The bed will be uncovered sufficiently to determine the continuity of level in the distribution piping which was found to be level in the north -south direction. Quick conversion of the bed to full pressurized piping is not feasible as the existing pump is not the current Orenco high pressure type pump, and a conversion would required a new pump, floats, and control panel. The leachfield cover will be verified as 3' after modifications are complete. This request should be considered a modification of the original permit submittal presently on file at MOA. The lift station will be pumped and cleaned by a certified sanitary pumper (JR's). We stand by our original design, and acceptable evaluation of the system by adequacy testing. We will also visually evaluate the condition of the leachrock/soil interface when the system is repaired and if deemed necessary, increase the bed size upon consultation with MOA. ERES will notify the MOA two hours prior, to allow MOA inspection of the open excavation if desired. We expect to require inspection October 5, 1992. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 EAGLE RIVER ENGINEERING SERVICES P. O. Box 773294 EAGLE RIVER, ALASKA 99577 Phone 694-5195 JOB SHEET NO. OF CALCULATED BY L DATE CHECKED BY DATE_ SCALE PRODUCT MIa Inc, W., Masi 01171. VHHr nw9 s• ~ 66*C77014 I -INE EA,50MEN7- N �i Lr vEcY, v n i € 4 l ttyjqq'' 0000 a�J 'p �opnca nco eeco�o�eFN<'"'� z I 1 \ C, AN\ -A dL: 49H� .W,� a4l.jvm.Wi1 ! LN�.MM� • I IG. 11 �o Lc / `� scA,,of.G, /JGd�sN 1�ISISz 1 HERESY yERTIFY THAT AH ACCURATE SURVEY Of THE FOLLOWING DESCRIBED "10"RTY evA Ia: -Lor 7. ab�c-Y,40SAMP30N f S7A7E �si1�_.e.._._.._....�:i i ' It,�.::._._ r• , RjCIM1DINO 011MCT_ ALASKA• WAS MADE ON AND THAT TI.TE ATmwlj EMENT$ SITUATED THEREON ARE WITWs J THE HTOPERTY LIHaS AND DO NOT OYER- LA>s Orr ENCAGAC7T ON THE FRO►ERTY LYING AD, AUM TTEIKfTO. THAT NO W NtQVf'MENTD ON THE TT1ppk71 scaft J I'� 1T LnNG ACVACEHT THERETO ETHJi,7A(A GM "' Mo#*LfSCAISED FTC"K" ANO THAT THd RE Are N:1 ROAD N16:1...3 M.A� E,� . y+�' wKYS TRAf"w*l" t.*ES YIS OR (PIWPI IOLF EASETMWB ON SAID PMP ft" tXCt" AS *rjrATTD "ME)". AREA PLi� 1 � NE K eArEu Tis. r.4pAYOF__ /i�• fosL, P-nOV%SSf*4^L LAND KMVK , P.O. SOX 210"A w,lliru E, lor+w SON. WASILLA. ALASKA fl~' I 14071 .ITO.IN4 Louis Butera, P.E. Registered Civil Engineer August 31, 1992 John Smith Municipality of Anchorage Dept. of Health & Human Services 825 L Street Anchorage, AK 999502 Re: Sampson Estates, Lot 7, Block 4 Dear Mr. Smith: RECEIVED AUG 31 1992 ; A,ichorage �. Human Services Pursuant to a field inspection performed August 31, 1992, with a representative of your department, and referencing the reply letter from your office, the following items were confirmed. The leachfield has three feet of soil cover and therefore meets MOA code requirements. The leading portion of the field is also insulated, and therefore has five feet of effective soil cover. The cleanout pipe at the west side of the bed was found to be 0.6' lower that the three cleanouts at the east end of the bed which were relatively level compared to each other. Without digging up this west cleanout, it is not possible to determine if just the cleanout has settled or separated, or if the piping system is at fault. As these are the two deficiencies mentioned in your letter regarding denial of a Health Authority Approval, we propose the following to allow approval: 1. Excavate and uncover the cleanout and determine if settlement is localized, and if so correct. 2. Based on our excavation as outlined above, and homeowner's decision, level out the area that is affected, or place 1'/a" laterals throughout the existing bed to provide a fully pressurized system. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 0`�4 Tom Fink, Mayor Department of Health and Human Services 825 "L" Street P.O. Box 196650" Anchorage, Alaska 99519-6650 August 27, 1992 William Hollingsworth P.O. Box 670969 Chugiak, AK 99567 Re: Lot 7, Block 4, Sampson Estates On-site Wastewater Disposal System Dear Mr. Hollingsworth: a This office has reviewed available file information as well as conflicting data submitted by Eagle River Engineering Services and Constructing Engineers pertaining to the adequacy"of the subject wastewater disposal system. We have also conducted two field inspections of the system. Based on our review,'we have determined that the current condition of the wastewater system does not meet requirements for a Health Authority Approva`l;. Available information from all sources appears to indica-te that the original system was not installed as designed or --as required by municipal regulations. The two primary deficiencies, which are clearly indicative of poor workmanship, include: 1. The system, when initially constructed, was not completely or properly covered and/or insulated as indicated on the inspection report. Recent efforts to place more fill over the system appear to have only partially addressed this problem. 2. Field measurements indicate that the bed is not level. The west end of the bed was found to be approximately 0.8 Ft. lower than the east end of the bed. This condition has likely contributed to the poor performance of the system and is considered a major deficiency since the low end of the bed is the first part of the absorption system to receive effluent from the lift station. 7J J7 ✓ �t ave O cs /E' YC'. ��✓ �' ' (t%tet X1.1"� 4f'��� � � �� C.e���, lr i C��li✓y� % c� (� C�i�'�t C!_.�r�l� ��t�� � rAri�� �<�GJ f�i-c,�..�� ,`�� William Hollingsworth August 27, 1992 Page 2 Prior to issuance of a Health Authority Approval, this office will require that the existing absorption system be upgraded in accordance with current regulations. incely, J ESmith, E. Pio gram Manager, On-site Services cc: Lou Butera, P.E., Eagle River Engineering Services Chuck Landers, Constructing Engineers August 20, 1992 John c 1 L 8< Ai Re: Dear At yo; regards Louis Butera, P.E. Registered Civil Engineer ����pp-^^ 1/� 501m ",pr�19 Z, &7 dIL, I .iaf� w C / , n CY 0, 0 The lea( Our initi (NE). A. n 3 next to d excavated condition, excavated gravel and � Rather than , over a one m system was at NW monitor Subsequent rea v RECEIVED AUG 2 01992 'crPality of Anchorage 49 Pelth & Human ServiceS tion of our test and findings failed by that firm's testing. n to be at 10" (SW) and 0" was occupied. A test hole field level was dry. We i was found to be in good econd hand dug hole was avated 1' below the bed We believe thisthe following reasons: chose to add 450 GPD Id level indicating the water, the level in the " after the weekend. 1. The fields performed adequately for the current owner, i.e., no problems indicated. 2. Test holes show no ground water encroachment or perched water table. 3. Excavations into the leach gravel show the gravel to be in good condition. 4. Addition of water at 450 GPD rate, over five days, shows no effluent surfacing or in adjacent test holes, and an apparently stabilized level in the leachfield. 5. After the long term test period, the leachfield recovered. This leachfield is difficult to test by the water addition and immediate recovery method. Beds by their design take water over a large area, and therefore are more difficult to evaluate. With P.O. Box 773294 • Eagle River, Alaska 99577 • Telephone (907) 694-5195 • Fax (907) 694-3297 Page 2 Sampson Estates, Lot 7, Block 4 August 20, 1992 a lift station involved, as was the case here, the water is added in doses. Depending on when you read the levels in relation to the time the field is dosed there may be severe fluctuations in readings. We believe that this leachfield will perform adequately for a three bedroom residence. If future upgrade is required, it is recommended that leaching area be added to the original system, and there is room for this addition. We did find insulation over part of the field, and the original contractor has placed additional earth cover to a depth of 3.0' over the entire field. If you have any questions please call our office at 694-5195. Sincerely, Louis Butera, P.E. EAGLE RIVER ENGINEERING SERVICES P.O. BOX 773294 EAGLE RIVER, ALASKA 99577 (907) 694-5195 DATE:' /?/,Z7 — 1�zq INSPECTOR:— 8ti '4 LOCA'T'ION: Lu* 7 !S/e1 --S +s p.re-v -Er-P' SEPTIC TANK SIZE: /O0054( S-voyt/ hftSrtSYSTEM TYPE: NO. of BEDROOMS: PUMP PEAK FLOW RATE: y: e G.r+ JOB NUMBER: /V ****I************************************************************************** rime Total Meter Reading Well Level Tank Level Monitor Level Change in Level NOTES l: 3G3 -SCK ,!r7 oY y6 / s `{ bw niv virorz A"07- ccw,er F 'DO "'�+e+er U�v � ttTi/�7�o f42 TEST 3 30 7, 8/ S GPS k1 -?So 8, 7S- 1"zF 2F - — - y.b3 — 8, 75 — -- $(ib 8a6v�-- --- ----"1.--- — ---- -- —BOG J 7 q'0 e.k /3Sr - o" J teJt s;r��eu(. /-;S (( --- - �� --- 44 +e rKms— _— O.JO --_-- _ - T E S R E S U L T S PASSED FAILED REVIEWED PY.,%F DATE: EAGLE RIVER ENGINEERING SERVICES P.O. Box 773294 EAGLE RIVER, AK 99577 694.5195 MODUCT 204.1 Hilq'i Sheilil 205.1 (Padded) IM., Grolon, W51.01471. To Order PHONE TOLL FREE 1.801225 SM JOB SHEETNO. OF CALCULATED BY GQ DATE CHECKED BY DATE e /- 346-'3000 694-9098 1)A V!V . i--13- 92 LEGAL DESCRIPTION L:7 64- 1 PERFORMED FOR ��►1~���ili\ SLJUV'�•• � �Y'e,•2 C\fie e� HU -740%R OF REPRooms .�5r.. x ISO GPD/SEDRo wl r. ����Q:GPD Rrm"' rilum ^AWK SIZE .. a. )(1,)6 cma, NUMBER OF COMW!RTA ENTE), Z - a,.1 Mrl Y@JIM i d'LOr'V � (RwEA,LFXKG M`dN.].iMi.''i C3`:3Ct { _�__._ ..—ti _. ._ ti Flct.t? /-trtS f•zr-i T (bm—� 1U - -�---•3oC. �c) A {- ----- p i'tL.P..'3-p�lt,-L"" •if.? 1 N�;�ry*' ; - ' [ - 5's k"J W {1-(L`Y�- �t�-!`t-Vl� tN �=-���� i'=�.v �I-fe Fs +".`r;Y.�€._I fir.--�}�`S-{,v✓ULSL�' J>U�21 N(� �-�7_=5?�kNG' R Nt3i�`� L.r�.3 ai�3Rtt_::.t �t'It 1_tz��.. .1 s�,R�a., •rr>'t��� C)!C– }l Est.s�-��i.>,r..? REPLACEMENT ABSORPTION SYSTEM DESIGN DETAILS SCOPE OF PROJECT: Design a :replacement wastewater system for an existing 3 - bedroom single family house. Lot is served by an on --site private well; replacement absorption system is to be located at same location as existing failed system. Existing absorption bed to be completely removed as shown on S4. ABSORPTION AREA CALCULATIONS: Minimum Required: 3 Bedrooms x 150gpd/bedroom = 450 gpd capacity * Soils rating, proposed absorption field (bed), 0.4 gpd/sf Minimum sizing: 450 gpd - 0.4 gpd/sf = 1125 sf absorption area Existing system 18' x 501. Use 24'W x 501L x 0.51D = 12'00,,sf for bed area, with 1 1/4" pressure distribution laterals @ 6'cemter as shown on S3 and S4. IMPACT ON ADJACENT LOTS: Where are no public wells within -200' of this absorption system. There are no private wells within 100' of this lot. Since the existing absorption system is being replaced in the same location, the proposed absorption system will have no additional adverse impact upon any adjacent lot. � r DESIGN DETAILS PROPOSED REPLACEMENT WASTEWATER ABSORPTION SYS LOT 71 BLOCK 4 SA14PSON ESTATES SUBDIVISION PREPARED FOR: WILLIAM HOLLINGSWORTH 22651 GABRIEL CT CHUGIAK, AK, 99567 ad3tt- - CONSTRUCTING ENGINEERS 346--2000 FNGIN AL - - ' 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 7-23-92 DRAWING N 92 -sl -07-3 1 SITE PLAN—REPLACEMENT WASTEWATER ABSORPTION SYSTEM UN5v5bivID SEGrroN LrNE 334 5Zc LWr.- E5 E;r NrN� taWtt 6�45rrlw& 94W .ro / \ _. PND LrPT jrj£1rHFJ TEIrr R t. 1 fzlep 3aD � T�pr 4101 / a� �i "cp /yx d` "pa,/ SITE PLAN DETAILS PROPOSED REPLACEMENT WASTEWATER ABSORPTION SYST LCAT 7 BLOCK 4 SAMPSON ESTATES SUBDIVISION PREPARED FOR: WILLIAM HOLLINGSWORTH 22651 GABRIEL CT CHUGIAK, AK, 99567 ,;CALE: 1" = 100' DRAWN BY CAL CONSTRUCTING ENGINEERS 346°-2000 9601 BUDDY WERNER UR 694-9095 ANCHORAGE, AIC, 99516 7-23-92 DRAWING N 92-52-07-3 ABSORPTION SYST2M n2SIGN �zbr« 1 Gf ap°. Imo. I SITE PLAN DETAILS 'k% PROPOSED REPLACEMENT WASTEWATER ABSORPTION SY 7N SLOT 7 BLOCK 4 SA14PSON ESTATES SUBDIVISION to!yll PREPARED FOR: WILLIAM HOLLINGSWORTH y_ 22651 GABRIEL CT CHUGIAK, AK, 99567 SCALE: 1" = 40' DRAWN BY CAL CONSTRUCTING ENGINEERS 346-2000 9601 RUDDY WERNER DR 694-9098 ANCHORAGE, AN, 99516 7-23-92 DRAWING N 92-S3-07-3 REPLACEMENT WASTEKATER ABSORPTION SYSTEM DESIGN DETAILS th p r� J F"' a J S v`d � NOT TO SCALE DRAWN BY CAL �Aressaa�a'sfs'�`ase:: axa�lw6c+A^,a�a s� � .. ra IN 15{41 e S $'�•«L.+'��`' S s 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 7-23-92 DRAWING N 92-54-07-3 P-1LLQp/r'l ACpiiN6 vLA<e-D YAa-%r�' NATVO,L 7� lY�+ s �--•�"'� � rte" SANPV� SI L-tW CyM ..,•ar^'~y� .�®. 73�+`++.�M oda +-4t Lw 0. Tv �MrL Lc+y1y9'IW iw G�r�dE G12R(Jf• �'fD (h'n'.1 O.G. i -2, n+11+7 cnv6R r roll vnST 6u6r; of F16Lp LAYgR. w i TH SAN D -M i uv RYl dJ Z41 p1gopo5eo clZaS'S- S r;e'i1 SYSTEM DESIGN DETAILS PROPOSED REPLACEMENT WASTEWATER ABSORPTION SY LOT 7 BLOCK 4 SAMPSON ESTATES SUBDIVISION 6arom$7� `, PREPARED FOR. WILLIAM HOLLINGSWORTH th p r� J F"' a J S v`d � NOT TO SCALE DRAWN BY CAL �Aressaa�a'sfs'�`ase:: axa�lw6c+A^,a�a s� � h S $'�•«L.+'��`' S s Lc+y1y9'IW iw G�r�dE G12R(Jf• �'fD (h'n'.1 O.G. i -2, n+11+7 cnv6R r roll vnST 6u6r; of F16Lp LAYgR. w i TH SAN D -M i uv RYl dJ Z41 p1gopo5eo clZaS'S- S r;e'i1 SYSTEM DESIGN DETAILS PROPOSED REPLACEMENT WASTEWATER ABSORPTION SY LOT 7 BLOCK 4 SAMPSON ESTATES SUBDIVISION 6arom$7� `, PREPARED FOR. WILLIAM HOLLINGSWORTH th 22651 GABRIEL CT CHUGIAK, AK, 99567 v`d � NOT TO SCALE DRAWN BY CAL �Aressaa�a'sfs'�`ase:: axa�lw6c+A^,a�a s� � CONSTRUCTING ENGINEERS 346-2000 S $'�•«L.+'��`' S s 9601 BUDDY WERNER DR 694-9098 ANCHORAGE, AK, 99516 7-23-92 DRAWING N 92-54-07-3 ss'.fa« bs u�i T i Municipality of Anchorage ( DEPARTMENT OF HEALTH & HUMAN SERVICES '�'� E'.e ygOy Stvnmm�c4f'!PN 825 "L" Street, Anchorage, Alaska 99502-0650 v � A No. 7732.0 SOILS LOCA ® PERCOLATION TEST •"UNAL PERFORMED FOR: _ �Lt1 1 r:vM -, j_�-�_\n� S w�= DATE PERFORMED: LEGAL DESCRIPTION: t^4' 64 5bw,r6 ,n IsSTownship, Range, Section: N I/a. 3-"n 't1J -Z 10 DEPTH SLOPE SITE PLAN — (FEET) 1 2 .3 I 4E 6 'Pei 7 �3 3 10 — 11 12 13- 14 15 1 11 1!3 19 20 OV AU bur1 0v9Qv1\:.y 52nel 1 lFtrwc., z +111t Sil� e�n�7p�l+c, r �tl+ IQ'A�Q 782C tf t N WAS GROUND WATER ENCOUNTERED? ry0 _ S IF YES, AT WHAT _ OL u/ DEPTH? P E �— Depth to Plater After - fAoniloring? fvA -Date: Reading Date �i Gross Time Net Time Depth to Water Net Drop 11Z.1 19L - 5'1A„ Ion, gg PERCOLATION RATE __ (m�nutesiinch) PERC HOLE DIAMETER _SL_ TEST RUN BETWEEN !"'_ FT AND T" SBFT y 1 COMMENTS "I`}— 'PC'P // PERFORMED BY: S.0 S �^+rig �tCj 1 a i c�jYJrS CERTIFY THAT THIS FEST WAS PERFORMED IN ACCORDANCE WITH AL.L STATE AND MUNICIPAL C UIDELI NES IN EFFECT ON THIS DATE. DATE: _j &Z-2? 72-008(Rev.4/85) yas a Municipality of Anchorage � : , , ":, ri • - • vaaen�Rsrr DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street Anchorage, Alaska 99502-0650 l&ig -s1 NO. 7932.9 o ", SOILS LOG — PERCOLATION TEST v�,a��hJvrt*22, 'f'w PERFORMED FOR: (AJ) .. __ � VV)��)T1C� 1ti7—_ — DATE PERFORMED:, Y LEGAL DESCRIPTION: L -t _ -ah'`ps., c -,t township, Range, Section: �„�y'�ny. 3 '7'Ii5/V JL I t1J DEPTH SLOPE SITE PLAN! 1 2 3 1 5 0 7 3 1.� 11 12 13 14 15- 16- 17- 13 19 _. 20- 0-- -peer, P* 7- -prP*7- WAS WAS GROUND WATER ENCOUNTERED? N� S IF YES, AT WHAT L DEPTH? O A E Depth to Water After Monitoring? _ H�)- Dale: Reading Date Gross Time Net Time Depth to Water NetA Drop CD. 1Om, IL7m�r, II7x+k;NIll IT Ib' A� I Ca rr, l� PERCOLATION RATE _ fb (minutes/inch) PERC HOLE DIAMETER 1 -EST RUN BETWEEN _ .._ FT AND FT � � oll 5IL.T UaN,.;2s) COMMENTS j�YCC6Lq.'j-t,q�nl '9 ers UG'T°S *� PERFORMED BY: CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITFI ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE, DATE: 7 Lz -�L/,(5' Z- 72-008 (Rev. 4/85) -- Municipality of Anchorage �$ 6 DEPARTMENT OF HEALTH & HUMAN SERVICES!��e�ioa® Net Time Depth to Water 825 "L" Street, Anchorage, Alaska 99502-0650 © "see o SOILS LOG �-- PERCOLATION BEST �� ��g�, K10.2, o ^aFt I PERF=ORMED FOR: w��, �1 DATE PERINtFORjJ.;. LEGAL DESCRIPTION:_'5;ivn/sSSrtrv_�-a•2'� Township,Range,Section : Nw'/A 53-71 S7 iZtlr� DEPTH `Y`�='` SLOPE SITE PLAN I 3 i) �j H 13 10 11 1�! 13 14 15 16 17 18 19- 20 - l G #3 WAS GROUND WATER ENCOUNTERED? N� S IF YES, AT WHAT L DEPTH? 0 P E Depth to Water After Monitoring? Date: Reading Date Gross Time Net Time Depth to Water Net Drop © ?-Z 1 9Z o •, Z Izf �Z�., f_iIch PERCOLATION RATE Z•� (minutes/inch) PERC HOLE DIAMETER G ` TEST RUN BETWEEN FT AND —7 FT COMMENTS G.ULA�%Cl C>"J I V L'q`5 F4�Ll lC UNCJ�iP N . SCS f= PERFORMED BY: Lrb((l$6Ue;`6, � ) t ;h�.2, � I _ LSC\� c .v. -u _ CERTIFY THAT THIS TEST WAS PERFORMED IN -- ACCORDANCE WITH ALL STATE AND MUNICIPAL GUIDELINES IN EFFECT ON THIS DATE. DATE: -7-7. _�47_ 72-008 (Rev. 4/85) _ FeS J),* Ln- 1�-I ® Municipality of Anchorage DEPARTMENT OF HEALTH & HUMAN SERVICES 825 "L" Street, Anchorage, Alaska 99502-0650 SOILS LOG — PERCOLATION 'EST I l�eta PERFORMED FOR: �,)lwQY-Oh DATE PERFORR,1 FsQ� t LEGAL DESCRIPTION: L-4q;"5'npsbn (70- Township, Range, Section: Nw`1453`r-p SN UEPTH SLOPE SITE PLAN (FEET) b%j Q w- b%J r `"/ SII Si R-tj p r'4 7 _ 2� 4 8 9 10 1", 12 13 14 1 f; 1f li 18 10- 20 - Ia I I L—I—J WAS GROUND WATER ENCOUNTERED? _ No S IF YES, AT WHAT L DEPTH? PO E geplh to Water After Wnitoring? _ NA (late: ul) Reading Date Gross Time Net Time Depth to Water Not Drop N 7(I F eQ L\ i 'Zrly. 1/8" Ink__ PERCOLATION RATE Z4 (minutes/inch) PERC HOLE DIAMETER 811 _ TEST RUN BETWEEN 9f FT AND/ S —F7 COMMENTS PERFORMED BY: ��'` ✓C�''�+� �Q_.� CgyS I C�}6.,..�¢c.- CERTIFY THAT THIS TEST WAS PERFORMED IN ACCORDANCE WITH ALL STATE AND MUNICIPAL_ GUIDELINES IN EFFECT ON THIS DATE. DATE: -7-2-?-92- 72-008 -L,-9Z72-008 (Rev. 4/85)I 'BEST �L MUNICIPALITY OF ANCHORAGE DE ATMENT OF HEALTH AND HUMAN SER. .ES Environmental Health Division 825 "L" Street, Anchorage, Alaska 99502, Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT Name DISTANCES qq `I /CiS,or.. 1-,12� ?%, / %iG .-�v L/7/'N, /ter...,! L✓¢!/...u.✓ TO SEPTIC ABSORPTION Address FROM TANK FIELD WELL Po & q / /, c ! %��.� �Nr�ixcrc � `!� !�7 Phone(s) Permit No. No. of Bedrooms WELL �00 ! /!» �S5--7,;Sa F7— /3/ 3 LOT LINE 73,57 LEGAL DESCRIPTION Lot Block if Subdivision 54 • so .te r T� re r FOUNDATION / / / %g S$ S` Township, Range, Section �� Se G AS-BUILT DIAGRAM (Show location of well, septic system, property lines, foundation, driveway, water bodies, etc.) TANKS S❑ HOLDING =f " dy.1 aS Manulacfiner Capacity in gallons /}.✓ol /doh d0 1r F} 3 Material No. of Compartments TYPE OF SYSTEM OK ❑ TRENCH BED ❑ W. DRAIN ❑ OTHER m Depth to pipe bottom from original grade Total depth from original grade FT " 7; FT 7;L \ 1 F added above original grade Gravel depth beneath pipeb 4FT /! FT t Gravel length Gravel width S 0 FT /S FT h SG dt Total absorption area I Distance between lines 9 Ov S FT `p'7 ° Q /!✓ Ce�f 6 FT ` Q Number of fines Soil rating Pipe material U 3 Ck //j SOFT Installer Date Installed QC1t•✓ Gars f�-,..�ftoN 'Tc._/ .3 — /i1-7 WELLS ' N PRIVATE ❑ OTHER Odentiiv) Classification (A,B,C) Total Depth Cased to W LL FT FT Installei Date Installed: REMARKS: f pljrt4 / iii /f{M eye" Ae'! Scale: ENGINES S SEAL L" J' J�Y''.n� !�' Ye �t ru r� �we� Inspections Performed by-.-�'SC`z"� SE Eagle River Eg41{,IporIng Servide§ %b llJOLJ fo Ei Date: P. 0 Put 773294 ���h� o,o°oEoo f�r �c�?v o °� J� Eagle River, AK 99577' n �ceiSeesC ��ce7rec/�n745195 to'"°°�ydi; �O 0005 c •• a a°°o so 000°ec n �� cerlily that this inspection was perlormed according to all�� 9��gaeoe°0000 oa ,00�pp baeaon^ E� Louis A. Dulerct �� Municipal and Slate guidelines in effect on this date: 6734 % 7 -p yjr �SY ]� x < ��, 3• Health Department Approval: Date 7ca3✓' lF A L[FT STATl�N IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) .... PERMIT AND INSPECTION ������� OBTAINED; DEPARTMENT OF f|EALTH AND ENVIRONMENTAL PR�TECTION (2) AS�BUILTS 825 L STREET� ANCHORAGE� AK 99501 264~4720 _~�� ....... �`ERMIT NO: 870131 UPGRADE DAlE ISSUED� 06/11/87 APPLICANT: ERES / ALASKA MUTUAL BANK ADDRESS: POUCH 99003 ANCHORAGE� AK 99509 CONTACT PHONE: 258-78O9 LEGAL DESCRIP: SUBDIVISION: SAMPSON EST" LOT: 7 BLOCK: 4 SECTION: ',.:I TOWNSHIP: 15N RANGE: 1W LOT SIZE: 36000 (SQ.FT. OR ACRES) I certify 1. that: I am [amiliar with the requirements �or on-site sewers and wells as set forth by the Municipality o� Anchorago (MOA> and the State o[ Alaska. 2. I will install the system in accordance with all ph codes and regulations� and in compliance with the design criteria o{ this permit. J. I �ill adhere to all MOA and State of Alaska requirements �or the set L;ack distances �rom any existing well, wastewater disposal system or public sewerage system on this or any adjacent or lot. nearby lF A L[FT STATl�N IS INSTALLED IN AN AREA COVERED BY MOA BUILDING CODES, THEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; W[7-1 (2) AS�BUILTS it SIGNED APPLICANT: ERES / AL �y ISSUED BY ' - , ~ _ DATE: DATE: -..... ... � eve -71 -de -7 � . [� �� `��� June 10, 1987 Mr. Steve Morris Civil Engineer, On-site Services Municipality of Anchorage P.O. Box 196650 Anchorage, AIS 99519 REP: Sampson Estates: Lot 7, Block 4 Septic Permit, Lot Line Waiver Dear Mr. Morris: We are submitting for an On-site Septic Permit for the above referenced lot, and a Lot Line Waiver to 51, for the proposed leachfield and the existing septic tank. A)e-r 4e esSas deo. /ae eas�rya7. � 6l///dv The soil for the proposed leachfield is of better quality than the existing leachfield and allows room for future replacement. This should not affect the neighbors future septic system installations, because the lot line is adjacent to the road right of way. If there are any questions or concerns, please feel free to call me at 694-5196. Sincerely, L is Butera P.E. LB:bls attachments -0 LEGAL r`\ SPECIFICATIONS FOR ON-SITE SEPTIC SYSTEM Sampaon Estuteo- Lot 7, [3Iook 4 �, QEN�RA| I . Tho wmll und �,,ocptio pian jr-us fvr a ainqlu fam1Iy /s-,�oide:cr nnly. 2. The C�!nd or site plan sha.11 bm a parL of U}iss ypsoificwtion. 3. 8ll muter- iula zinc! workmonohip ohalI tmont of Hoalth and 1313vt13 Dmpartmmnt Of Environmaot�l Cons�rvatioo requirc^ m�nta. A. A 1 aoil tosL: arm in6visory to the deoign and xro Co bo! vorifiod nr modifi�d in the fiold by thu �nAi�c, 6'r. S All ox�avation� �nd dm;ths al r, �dviuury and ore to �: vorifim� or modified in tho fimId by ta oontruotur to mnet Munic;ipality of 0nohVracm, of Environmootal 0oosarvatim� reqoir�mcnty. � It is tho rm�ponniIity of 1, ho ownc,�r to nbtuin oIl nmcosoary permj-ta Vr o�oomento mnd to Ito uoy adjace nt multi~Tam ily wolIso . 7. Th� cxouvativn 'L so t bo uxaoLly in tho uim� shown on Cho �oita plan, uny deviation requiroco snginaor upproval. 8. It io ulwa "ya reoommundcad that za surveyor Ioccitm tho line potion and thm location of any masooments3. OLD 1. Thu bod ia to follow thm nuturml lund oonCour to muintuin uni{orm totzil depth of tha bmd bottom. bot,tnw of tha bmd sohmll bn lovel' plus or minum 1. "i''. �. Thm tctmI depth of tho bed oouzivotion ia not t oxccmd 1" xt uny point. �. Any ovcor 0x0 11v4tion of t naturml s and is; to bo rop.lzi. d by a/i impvrted filtar sand - 5Tha bed gravol im to bc covered with tyPaar fubrio muterial 6. Soil or owfib inmtion of soil annd extrudmd �L) oalrd ineulation to � dcptI of �" o/ (.quivmlnni� iso tr> be placsd ovnr thm Ieuohfiald /. Thm arco a ovor 1:11co bnd io to ke finioh grudod to provont ponding wf surfuuo wator ruooff Q. Thm oal )tiV tank and lcauohfiold momt nVc, Um olosmi than 100` to uny o�(isting pr wnll, lSO' to mny Clmso ''C^ wmIl, o 200 foet Mo xny oommonity wmll, RECOMMENDED LEACHFIELD DIMENSIONS TOTAL DEPTH c l" GRAVEL UFPTH 6'' HED LENQT|| � S0" 20D WIDTH i8 801I Rating -� -200 adjusted, Budroom Czipaoity � 3 3eptio Tank Size �': 1000 ***SAND FILTER NOT REQUIRED DUE TO PRESENCE OF NATURAL SAND. ***LIFT STATION REQUIRED, MUST BE PRE -APPROVED BY MUNICIPALITY OF ANCHORAGE, WITH INSTALLATION TO ELECTRICAL CODES. 283' EX IST LFA—C-0--o 33' SECTI❑N LINE ESMT, I� ° "0 _ (a --- -------�� ° EXIST TANK -- --� o o c� � �T9Tl sT yo T 1�F.9cy / / t HSEO� <�� I yob o F IIRIVE WELL THIS LOT SURVEY WAS TRACED FREN AN _ \ AS -BUILT SURVEY BY AREA PLANNERS DATED 7 , WE ARE RESPONSIBLE FOR THEE SEPTIC PLAN ONLY RIGHT OF WAY — EXISTING LEACH FIELD NE:W LEACH FIELD x, µ- CLEANOUT SCALE, 1'= 40' WELL AND SEPTIC SITE PLAN v an LEGAL. _LOT 7, DLK 41 SAMPSON EST, OWNER: AK. MUTUAL BANK �QO 0 9080e�rOb C❑NTRACT❑R� N/A � _ a° Louisera E-6736 C®a EAGLE RIVER ENGINEERING SERVICES P❑ BX 773294 EAGLE RIVER, AK, 99577 694-5195 r SOILS LOG " MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 _ 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: A/c, /%'1 u-tua / 'd'an/!C DATE PERFORMED: ��a 9A7 LEGAL DESCRIPTION: �-0-f 7 d !k Z/ S4,, 4SDr✓ ES 7,* 7�-e.r T15 -1V /Q l t✓. Sic -,:r DEPTH SLOPE SITE PLAN TH' (FEET) %/O se. / D�C'GR ✓/c 1 2 .ANO We//y.cded (SW) 3- 4- 5 45 LGm�M L� 6 7 8 9 10 11 12 4 13 ®�°®.°.�t•���gb�q 14 e n so• •i• ""6186 ...o••• 15 j ", ..• .................g... 9 Louis A. Butera w ®` • a 16® C$ 6736 N_® 17 %®ROFESSO'�� 18 1 WAS GROUND WATER S ENCOUNTERED? Y45 LO S E IF YES, AT WHAT DEPTH? Reading Date' Gross Time Net Time Depth to Water Net , Drop So<+ct 6 / IS7 " la : 30 20 -{ uPERCOLATION RATE /a (minutes/inch) l77 4/4f.R. TEST RUN BETWEEN a �Z FT AND —'3_ FT COMMENTS fiQuum.e�. fe4 Sy67--e+ I' 7-6*4/ Af4tA ,V/Sa Not F,71 Qs NCedo-sl, bL-,f,5 6a sed o.,/ oi06 ��Q.A'. (lel ,x-er✓at.✓<� , Eagle River Engineering Services PERFORMED BY: P. 0. BOX 773294 CERTIFIED BY: �� DATE: Eagle River, AK 99577 694-51>>95 72-008 (6/79) /fe - 77-4 c � lvila .3 11 SOILS LOG MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION O" PERCOLATION TEST 825 L. Street, Anchorage, Alaska 99501 264-4720 SOILS LOG — PERCOLATION TEST PERFORMED FOR: GIk IJ'1liT aQ L &ANtf DATE PERFORMED: V 2 9z87 LEGAL DESCRIPTION: Ao f 7 ,(j/K y ES to kcx 7 -1 -5 -Al . of/w Sf-c 3 bA=vTAA 41 SLOPE SITE PLAN �H �2 1 2 3 4- 5- 6- 7 •5•6•7 8- 9. 10- 11 - 12- 13. 14- 15- 16- 17- 18- 19. 4•15- 16- 17•18•19 S4Nd Poor% /rr�o.(GcQ- `S p) SI/73, 410 d -(SM) CGrn/A1.9. N, ■IMMEMEM'M■■■, ■INEM■NN■MN MIENNEE���■ 1PM■■■■NEEN NUMENNEEM■ ■N■E►.N■o ■■.M■■■■■. ■.W■■■■■■■ ■■■■EMEEM■ ■■■■■■■■■■ WAS GROUND WATER S ENCOUNTERED? YEr L G S O E. IF YES, AT WHAT DEPTH? Reading Date Gross Time Net Time Depth to Water Net , Drop SOAN 33 /O vn..✓ 9 I�G 3 I�/G 2 rI /i : Y v /o a ///.t a Yip dee 4ela - iv vIs a. / /So 20 PERCOLATION RATE $3�/4'2 (minutes/inch) TEST RUN BETWEEN 911�i FT AND 3 FT COMMENTS ereCc-I~-�wc,C x4aCs',ic /?.qs-eot o7. .1,ao Eagle River Engineering Services PERFORMED BY: P. 0. Box 773294 CERTIFIED B DATE: 6 Eagle River, AK 99577 694-5195 72-008 (6/79) <viv kn.. o/ion MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH & ENVIRONMENTAL PROTECTION ENVIRONMENTAL ENGINEERING DIVISION 825 LStreet -Anchorage, Alaska 99501 Telephone 264-4720 ON-SITE SEWAGE DISPOSAL SYSTEM AND/OR WELL INSPECTION REPORT NAME Built-Well Enterprises c/o GEOLAB PHONE 344-8042 �,'] NEW EJUPGRADE MAILING ADDRESS 1131 E. 76th Ave. #101 Anchoracre,Alaska LEGAL DESCRIPTION Sampson Estates Lot 7 Block 4 Sec 3 T15N R1W LOCATION NO. OF BEDROOMS Peters Creek - Gabriel Circle 3 DISTANCE TO: Well 02' proposed Absorption area 7' Dwelling 20' PERMIT NO. 850012 c)Y I__ Q Manufacturer Greer Material Steel No. of compartments 2 wF y Lin. capacit in gallons 125 gal IF HOMEMADE: Inside length NA Width NA Liquid depth NA pJ O Y DISTANCE TO: Well NA Dwelling PERMIT NO. Z ZFI = Manufacturer Material Liquid capacity in gallons OU DISTANCE TO: Well 119' proposed Foundation 37' Nearest lot line 10' PERMIT NO. 850012 J Z z z¢ No. of lines 1 Length of each line 70 Total length of lines 70' Trench width Distance between lines F 36'mches - F Top of tile to finish grade Material beneath tile Total effective absorption area 0 4' 6' of washed rock inches 840 sq.ft. w Length NA Width Depth PERMIT NO. a 4 F LU Type of crib Crib diameter Crib depth Total effective absorption area LU V) DISTANCE TO: Well Building foundation Nearest lot line Class Indiv. Dept Driller Distance to lot line PERMIT NO. W n t drilled ye DISTANCE TO: Building foundation Sewer line Septic tank Absorption area(s) OTHER L+ PIPE MATERIALS ASTMD2729 in drainfield.Sch 40'AB_S_ . SOILTESTRATING from house to field and 262ft2/BR cleanouts. INSTALLER _ Pieratt Excavation h REMARKS 2" Dow burial grade insulation over ®, tank. Newspaper over drain rock /7ll A 4 O d C �00000000000 y�� GO£.:5 2248-- LLL APPROVED DATE LEGAL <viv kn.. o/ion PERMIT NO: DATE ISSUED: /~\ --� P"JUL-11 jr--� - �C-:: Y ---II C"!���� DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION 825 L STREET; ANCHORAGE, AK 99501 264-4720 850012 01/11/85 ~~~��.H.: !F:�.: "E'-: if"Z 11"11 :111 -11" APPLICANT: C/O GEOLAB BUILT- WELL ENTERPR. ADDRESS: 1131 E 761'11 1:11101 ANCHORAGE� AK 99502 CONTACT PHONE: 344^8042 LEGAL DESCRIP: SUBDIVISION: SAMPSONESTATES LOT: 7B�OCK: 4 SECTION: 3 TOWNSHIP: 15N RANGE: 1W LOT SIZE: "9A (130`1"T^ OR ACRES) MAX BEDROOMS: 3 Listed below are the options available to YOU, in designing .our septi� system. Choose the option that best fits yo ur site" EE C.,': 11 -1 1 A 1 E U;.� 13 RAM X ski! DEPTH TO PIPE BOTTOM (FT") 4"0 `' 5.0 4.0 GRAVEL DEPTH(FT ) 6.0 , O.5 3.5 TOTAL DEPTH (FT.) 10"0 5.5 7^5 GRAVEL WIDTH (FT^) 2"5 23^0 5^0 GRAVEL LENGTH (FT,) 66,0 46,0 85.O ** GRAVEL VOLUME (CU.YDS.) 39,8 39.. 63,0 TANK SIZE (GALS) 1�000`0 ** 1,0O0,0 ** 1,000,0 ** SOIL RATING� (SQ"FT^/BR) 262 235 262 -k* GRAVEL LENGTH > 75 FT. REQUIRES MULTIPLE � RUNS (NQT EXCEEDING 75 FT" EACH) ** TANK MUST HAVE AT LEAST TWO COMPARTMENTS ^ ���� ���..... ..... ��..... �����..... ... ... . .....^� I certi�y that: I. I am �amiliar with the requirements for on. site sewers and wells as set forth by the Municipality Anchorag6 (MOA) c\f and the State of Alaska, 2. I will install the system in accordance with all MOA codes and regulations� an in comPlJi. ancewith the design criteria of this prermit. ' 3. I will adhere to all MOA and WWI Of Tor the set bac� distances from any existing well� wastewater disposal system or public sewerage system on this or -.-any or nearby lot" � ^4^ I understand that this permit is valid for at maximym of 3 bedrooms and any enlargement will require an additional permit, ' IF A LIFT STATION IS INSTALLED IN AN AREA COVERED BY MOA BU`LDING CODES� MEN (1) AN ELECTRICAL PERMIT AND INSPECTION MUST BE OBTAINED; (2) AS -BUIL -TS AILL NOT BE APPROVED WITHOUT AN ELECTRICAL INSPECTION REPORT; AND (3) THE ELECTRICAL WORK MUST BE DONE BY A LICENSED ELECTRICIAN, 3IG1\1ED ` DATE: �.... ..... .... ..... ~�..... ..... _~~�. ..... ..... �..... ..... .... .... ^�..... 4PPLICANT: C/O GEOL B BUILT~WELL ENTERPR, [SSUED BY � DATE: � _�-�_.... ..... .... ... ..... .... ..... ~.... ~..... ................... .... ......... .... �.. _..... .... ❑ SOILS LOG GEOLA13 PERCOLATION 1 1 31 E 76th Ave 1 01 TEST Anchorage, Alaska 344-0042 SOILS LOG — PERCOLATION TEST /�u�/.f• G(fQ �'� {2 Z!�!.y r) y/ Z4 S _ DATE PERFORMED: PERFORMED FOR: LEGAL DESCRIPTION: SLOPE SITE PLAN 10 _ f WAS GROUND WATER 11 / V'Q—r-J,.,�QENCOUNTERED? 1� 12 J �� / �r� IF YES, AT WHAT DEPTH? ' o e ` Z4 00000 0 000 oo0 0 h 15 OM SR. SMI i o 0 16 °° 2248 -Eo ° o V �rV rA O�®OOOC60° .if4 171<- �•E� 18 19 r Depth ie' of Net '-� Reading z Net Time Water Drop ■ti//l���s. 4 ■i�i�lO�Nr.a 4 ■�1��/a■®Prr��! REMONNONE 10 _ f WAS GROUND WATER 11 / V'Q—r-J,.,�QENCOUNTERED? 1� 12 J �� / �r� IF YES, AT WHAT DEPTH? ' o e ` Z4 00000 0 000 oo0 0 h 15 OM SR. SMI i o 0 16 °° 2248 -Eo ° o V �rV rA O�®OOOC60° .if4 171<- �•E� 18 19 20 h) COMMENTS PERFORMED BY: PERCOLATION RATE _ Z�Q (minutesh nc TEST RUN BETWEEN FT AND FT' - t CERTIFIED BY: KAMA L -cy DATE: — r Depth ie' of Net '-� Reading Gross Date Time Net Time Water Drop ■ti//l���s. ■i�i�lO�Nr.a 4 ■�1��/a■®Prr��! REMONNONE 7 6 20 h) COMMENTS PERFORMED BY: PERCOLATION RATE _ Z�Q (minutesh nc TEST RUN BETWEEN FT AND FT' - t CERTIFIED BY: KAMA L -cy DATE: — r Depth ie' of Net '-� Reading Gross Date Time Net Time Water Drop 4 7 6 /J • U O '• 20 h) COMMENTS PERFORMED BY: PERCOLATION RATE _ Z�Q (minutesh nc TEST RUN BETWEEN FT AND FT' - t CERTIFIED BY: KAMA L -cy DATE: — UB • '� Municipality of Anchorage '13 N ` On -Site Water and Wastewater Program{ (907) 343-7904 Certificate of On -Site Systems Approval Parcel I.D. 051-811-12 1. GENERAL INFORMATION Expiration Date: 9-21-15- Complete ,21"1S Complete legal description Sampson Estates, Block 4, Lot 7 Location (site address) 22651 Gabriel Circle Current Property owner(s) Ronald & Shannon Robinette Day phone Mailing address 22651 Gabriel Circle Chugiak, AK 99567 Real Estate Agent Day phone 2. TYPE OF DWELLING: El Single Family (w/wo ADU) ❑ Duplex ❑ Multiple Dwellings (Single Family and/or Duplex) 3. NUMBER OF BEDROOMS: Four 4. TYPE OF WATER SUPPLY: Individual Well 0 Individual Water Storage ❑ Community Class Well ❑ Public Water System ❑ Waiver/Variance request for: Lot Line TYPE OF WASTEWATER DISPOSAL: Individual Q Holding Tank ❑ Community ❑ Public Sewer ❑ d Received by�\Vl/�!f Date: COSA to be released to th n i nless othem ested by the engineer. COSA Fee $ a0 'Du Date of Payment 5/111145 Receipt Number ( 5 oQca COSA# Q5ct5/=9 Waiver Fee $ Date of Payment Receipt Number OL6 Waiver# 0506/0-34 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below. I verify that my investigation, based on procedures outlined in the Certificate of On -Site Systems Approval Guidelines for this application, shows that the on-site water supply and/or wastewater disposal system is (are) safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and -inspection, the on-site water supply and/or wastewater disposal system is(are) in compliance with all applicable Municipal and State codes, ordinances, and regulations in effect at the time of installation. Name of Firm Anderson Engineering Address P.O. Box 240773 Anchorage, AK 99524 Engineer's Printed Name Michael E. Anderson, P.E. Phone 522-7773 Date 5/10/2015 6. DSD SIGNATURE J� System #1 Approved for bedrooms a :MICHL F tt D€Rsory System #2 Approved for bedrooms �� AE f •, GE • 4381 Disapproved b1 fp p••,,,,•�p �n ROFES518 ®0` Conditional approval for bedrooms, with the following stipula6�ta®`® By; _ Original Certificate Date: J° i ! s5 The ur alt chomge Development Services Division (DSD) issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 5 by an independent professional civil engineer registered in the State of Alaska. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 7. ATTACHMENTS: COSA Checklist X Septic System Advisory Well Flow Advisory COSA blue sheet_('- :. c Nitrate Advisory Arsenic Advisory Other If more than 1 septic system is on the lot: COSA Checklist # of Structure served by this system Certificate of On -Site Systems Approval Checklist Legal Description: Sampson Estates, Block 4, Lot 7 Parcel ID: 051-811-12 A. WELL DATA NOTE: See Letter in File from Arctic Well and Pump for Well Data. Well type Private If A, B, or C provide PWSID # Date completed 311/77 unitary seal (YIN) Y Total depth143 ft Cased to >40 ft. FROM WELL LOG Date of test Static water level ft. Well production g,p.m, Well Log (Y/N) N Wires properly protected (YIN) Y Casing height (above ground) >18 AT INSPECTION 4/22/15 92.8 ft. 10 g.p.m. WATER SAMPLE RESULTS: Coliform —2--colonies/1 00 mL Nitrate 2.99 mg/L Arsenic ND ug/L Date of sample: 4/15/15 Collected by: Anderson Engrg. B. SEPTIC/HOLDING TANK DATA Tank Type/Material Septic/Steel Tank size 1,250 gal. Number of Compartments 2 Foundation cleanout (Y/N) Y Depression over tank (YIN) N Date of pumping New Const. Pumper Date installed 10/3/14 Cleanouts(Y/N) Y High water alarm (Y/N) N C. ABSORPTION FIELD DATA Date installed 10/3/14 Soil rating (g.p.d./ft2 or iflbdrm) •6 GPD/SF System type Deep Trench Length 2 @ 46' ft. Width 3 ft. Gravel below pipe 6 ft. Total depth 12-13 ft Eff. absorption area1,104 ftz Monitoring tube Y Depression over field N Data of adequacy test New Const. Results (Pass/Fail) For _bedrooms Fluid depth in absorption Feld before test in. Water added gal. New depth in. Elapsed Time: min. Final fluid depth in. Absorption rate >= g,p.d. Any rejuvenation treatment (past 12 mo.) (YIN & type) N If yes, give date D. LIFT STATION Date installed _ "Pump on" level at Datum No Add On Manhole - Gravity Flow to Absorption Trench. Size in gallons Manhole/Access (Y/N) in. "Pump off' level at in. High water alarm level at in. Cycles tested Meets alarm & circuit requirements? E. SEPARATION DISTANCES WELL ON LOT TO: 100' Septic tankllift station on lot > On adjacent lots >1 f1r), Absorption field on lot > 100' On adjacent lots > 100' Public sewer main >75' Public sewer manhole/cleanout >100' Sewer /septic service line >25' Holding tank >75' Animal containment areas >50' Manure/animal excrete storage areas >100' SEPTIC/HOLDING TANK ON LOT TO: Building foundation >5' Property line >5' Watermam >10' Water service line >10' Wells on adjacent lots >100' ABSORPTION FIELD ON LOTTO: 4'** Property line Building foundation >10, Water Service line >10' Surfacewater >100' Curtain drain None Noted Wells on adjacent lots >100' F. COMMENTS ** See Lot Line Waiver. Absorption fief Surface water d >51 >100' Water main NIA Driveway, parking/vehicle storage >10' Absorption Trench is in Section Line Easement. See Letters of Non Objection. G. ENGINEER'S CERTIFICATION I certify that I have determined through field inspections and review of Municipal records that the above systems are in conformance with MOA COSA guidelines in effect on this date. Engineer's Printed Name Michael E. Anderson; P.E. Date 5/10/2015 COSA brown sheet_10-10-12.doc i I � I IS `x•25 fl\ \ 1 \ \ I� fJ� \� N � % Q o a o No\ a to w 00 nN Z_ / x N N O s 0 oJ o� or JJJ m J o N I J ry \ \ m b^ 1 zZ J ON } . 11 F is 1}.a se's LL m SW \ / C( 7-. 82 IL> .9L9 \ fan ¢o x /mr N Nw .r H N \ ! p IL U Z 00 N a 216.34 �\ \ m N 09.1 1 \ � coi -'dm I U N F �w J w 0 I I O W U w I M 0 N I 0 LO II W J U N J s m En Q CL CL r O CL 0.: it a— v o m m ooto �� Na �`c0= May 10, 2015 Municipality of Anchorage Development Services Department On -Site Water and Wastewater Program P.O. Box 196650 Anchorage, AK 99519-6650 Subject: Lot 7, Block 4, Sampson Estates Subdivision Separation Distance Waiver Absorption Trench to Lot Line Dear On Site Services Engineer: A new absorption system was placed on Lot 7, Block 4, Sampson Estates Subdivision in October of 2014. The lot line was not .located prior to placement of the new absorption trench and it was laid out relative to the existing house on the property. The trench is located within 4' of the west property line. The septic system on the lot to the west is more than 50' from the common property line and is not impacted by the location of this absorption trench. We therefore request a waiver be issued allowing the trench to be 4' from the west property line. Sincerely, Michael E. Anderson, P.E. Municipality of Anchorage e"` sPF4 v P.O. Box 196650.4700 Elmore Road 4 Anchors a Alaska 99519-6650 * 907 343-7 Department howl/www.Muni.cm/Ons Development Services Division On -Site Waw and Wastewater Program **** VARIANCE/WAIVER REVIEW **** Waiver#., Wd51034 COSA#: osc151206 Permit#: os 14 372 PID#: 051.811.12 Legal Description: Sampson Estates B-4 L-7 Engineer: Anderson Engineering Applicant: Ronald & Shannon Robinette Your request for a waiver of the required 10 feet horizontal separation from the absorption field to the property line has been approved. The approved separation distance is 4.0 feet. This waiver approval applies to the existing absorption field only. Any future upgrade to the on- site wastewater disposal system will require all separation distances. be met or another approval from this department.- [E epartment: ® The affected adjacent property owner(s) have been given a 7 day notice regarding this waiver. ❑ Notarized letter(s) of non -objection have been received from the .owner(s) of the affected adjacent property. ❑ Adjacent properties are not affected by this waiver. •..u.....-..■,r■rr.rr..u........u.u.....,�r.... rrY...a.. r..r.......r r..un Waiver is Granted: X Waiver is r4ot_d: n Date: l5 Approved- FdP F r�i7e� me of Reviewer 1................r............................................./......,�{ Municipality of Anchorage Development Services Department Building Safety Division + On -Site Water" WastewaterProgram ' 4700 Bragaw Street 3 P.O. Box 196650 9 519 Anchorage. AK 99onsita 0 www.muni.org/onsite (907) 343.7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL Q FOR A SINGLE FAMILY DWELLING Parcel I.D. 1. GENERAL INFORMATION COSA�z � QR o Z 7 Expiration Date: Complete legal description _SAMPSON FCTArro Location (site address) 22651 CABRIEL CIRCLE * CHUGIAK `AK 99567 Current Property Owner(s) DAVID do HALLEE BURKS Mailing addressDay phone C/O PO BOX 670941 • CHUGIAK AK 99567 Lending agency Mailing address Day phone Real Estate Agent GREG LANCASTER w CENTURY 21 Mallin address Day phone 884—'1016 Mailing 991 Nr1DTu Unless Otherwise requested, COSA will be held by DSD for 2. NUMBER OF BEDROOMS: pickup. 3 3. TYPE OF WATER SUPPLY: Individual Well TYPE OF WASTEWATER DISPOSAL: Individual Water Storage . Individual On-site . Community Class WellIndividual Holding tank 13 Public Water System 0 Community On-site Public Sewer O The Municipality of Anchorage Development Services Department (DSD) Issues Certificates of On -Site Systems Approval (COSA) based only upon the representations given in paragraph 4 by an Independent professional civil engineer registered in the State of Alaska. Certificates of On -Site Systems Approval are required for the transfer of title (except between spouses) for properties served by a single-family on-site wastewater disposal and/or water supply system. DSD also Issues COSAs upon request to homeowners. Certificates of On -Site Systems Approval are valid for 90 days from the date of issue for properties served by a private or Class C well and may be reissued with new water samples. (Certificates may be reissued for a period of up to one year with valid water samples.) Certificates are valid for one year for properties served by Class A or B wells or a public water system. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 4. STATEMENT OF INSPECTION BY ENGINEER I verifythat my lication, Systems Approval Guidelines for this app As certified by my seat aroXCehereto res outlined intthe Certificate of On - the v'Site SYa e) safe, functional and adequate investigation, based on p that based on the shows that the on-site water supply and/or wastewater disposal system is ( ection, the e of structure indicated herein. I furtheinvestigation rift't and insp for the number of bedrooms and type rage In compliance with all applicable Municipal information obtained from �hWa Municipality disposal system is(are) a from my on-site water supply regulations in effect at the time of installation. and State codes, ordinances, and reg phone 337-6179 Name of Firm CARNESS ENGINEERING GROUP, Ltd. 3701 E. TUDOR ROAD. SUITE 101 ` ANCHORAGE, AK 995( Address eer s Printed Name JEFFREY A. GARNESS, p•E• Eng'm Engineer's Comments: provide a thorough. In conducting this evaluation, GEG, Lf D. attempted to conscientious engineering analysis of the system in accordance with ADEC and MOA DSD Guidelines d Regulations. The reported results doscri �� naperformance fo lt f the d system under the conditions encountered at the time of the fest, and separation depend on the local soits condition, groundwater levels that may distances measured to readily Identifiable features. e o septic systems guctuate during the Year, and the water usage of the family being served by the system. uasfac a that These conditions are outside the control of the evaluator of the system. Satislarcofov deer results do not guarantee future performance of the system, nor do they 9 or future estimate of how long the system will continue to meet rt is for there are no hidden defects orencroachments. GEG, LTD. can thereforenot t nt of this any warranty reliance upon or use of this report by any operational requirements of the ADEC or MOA DSD. The C0'e of right whatsoever• the sole benefit of the party isnoot alisted above. uthorized, nor will it confer any 9 other person orparty 5. DSD SIGNATURE —Z,'�Approved for--3—bedrooms. _ Disapproved. Conditional approval for — Date 9l Ib o 0F ii0.rrcti �• ON-SITE ••�•1-" WASEW ATER pROGRAM ' with the filowing stipulations: % • •�\��� bedrooms., ' • • ... •'�5 `�� V Attachments: Arsenic Advisory COSA Checklist Maintenance Agreements Septic System Advisory meer's Report �— Supplemental Eng' Well Flow Advisory q Other Nitrate Advisory --- Original Certificate Date: By: (Re. 11105) Municipality of Anchorage Development Services Department Bu 9 Division On-site Waildinter &Safety Wastewater Program 4700 Bragaw Street P.O. Box 196650 Anchorage, AK 99519-6650 www.muni.org/onsite (907)343-7904 CERTIFICATE OF ON-SITE SYSTEMS APPROVAL CHECKLIST Legal Description: SAMPSON ESTATES BLOCK 4 LOT 7 Parcel ID:_et5:LZ_6 A. WELL DATA *SEE ATTACHED LETTER FROM ARCTIC PUMP& WELL Well type PRIVATE If A, B, or C provide PWSID# NIA --- Well Log (Y/N)_No� Date completed ^1985 Sanitary seal (Y/N) YES Wires properly protected (YIN) YES Total depth • 143 ft. Cased to •40+ ft. Casing height (above ground) 24 in. FROM WELL LOG Date of test 5gft-p.m. G Static water level �.�' Well production WATER SAMPLE RESULTS: AT INSPECTION _ 9/11/2009 101 ff 7.0 g.p.m. Coliform - (D— colonies/100 ml. Nitratel75 mg./L. Other bacteria colonies/100 ml. Arsenic:,) Qug,n. Date of sample:2009 9 9 2Z / Collected by: GEG Ltd. B. SEPTIC/HOLDING TANK DATA Tank Type/Material SEPTIC/STEEL Date Installed 77/9/1-- 98_ Tank size 1000 gal. Number of Compartments 2 Cleanouts (YIN)--__ YES Foundation cleanout (Y/N) YES Depression over tank (YIN) NO High water alarm (Y/N) YES :Date of pumping 6/_ 9/0` 9 _ pumper SANITARY PUMPERS C. ABSORPTION FIELD DATABELOW EfISTINC CRApE BED IS INSULATED Date installed _2/e/1ee7 Soil ratingp,d./f r ftbdrm'/0.4 ' . )— System typeBED Length 20 ft. Width 24 ft. Gravel below pipe 0.50 ft. Total depth __t3,BLft. Eff. absorption area 1200 ft' Monitorin tube YES 9 Depression over field NO Date of adequacy test 9/11 /2009 Results (Pass/Fail) • PASS Fluid depth in absorption field before test DRY For 6 bedrooms in• Water added 560 gal. New depth DRY in. Elapsed Time: 2 min. Final fluid depth DRY in, Absorption rate >= 450+ g.p.d. Any rejuvenation treatment (past 12 mo.) (Y/N $ type) NONE KNOWN If yes, give date D. LIFT STATION Date installed 7/9/1987 ' Size in gallons 5_ OO "Pump off" level at 44.5 In. Manhole/Access (YIN) YES High water alarm level atm—in. "Pump on" level at 405 . in. YES Datum BOTTOM OF TANK Cycles tested 3 Meets alarm &circuit requirements? E. SEPARATION DISTANCES SEPARATION DISTANCES FROM WELL ON LOT TO: 1 Septic tank/lift station on lot 100'+ Absorption field on lot N/A On adjacent lots 100'+ On adjacent lots 100'+ N/A Public sewer manholelcleanout Public sewer main N/A — 25'+ Holding tank Sewer /septic service line ------ 100+ Animal containment areas 5_ 0� Manurelanimai excrete storage areas _— HOLDING TANK ON LOTTO: SEPARATION DISTANCES FROM SEPTIC/g'+ Building foundation Property lines Absorption field 10'+ Surface water 100'+ Water main N/A Water service line — Wells on adjacent lots1 SEPARATION DISTANCE FROM ABSORPTION FIELD ON LOT TO: u /A 10'+ Building foundation 10'+ Water main Property line 10'+ ge 100+ Driveway, parkingivehicle store Water service line 10'+ Surface water�- NONE Wells on adjacent lots Curtain drain �KNOWN — F. COMMENTS G. ENGINEER'S CERTIFICATION 1 certify that 1 have determined through field Inspections and review of Municipal records that heabove systems are in in effect on his conformance with MOA COSA guidelines date. Engineer's Pnn ed Name JEFFREY A. GARNESS Date 9 �1 COSA Fee qi, ��09 Date of Payment � � Receipt Number a'/— �S . (Rev. 11105) Waiver Fee $ Date of Payment Receipt Number r aa�cP-14-2009 07:4.3 ■ a • a� FROM: 6940330 0 �f .yix • N O 100 a . n 70:3333246 c P.1 0 �f�'✓i1�t1 /o�g / L ASBUILT-NO CORNERS SET THIS DATE. SEWARD & I HEREBY CERTIFY THAT I HAVE SURVEYED THE SCALE%moo z FOLLOWING DESCRIBED PROPERTY, OA AND THAT ENS ACO EN S EXIST EXCEPT AS /a, INDICATED. IT IS. THE RESPONSIBILITY OF THE OWNER TO DETERMINE THE EXISTENCE OF ANY GRID: EASEMENTS, COVENANTS, OR RESTRICTIONS ys✓iS�° WHICH DO NOT APPEAR ON THE RECORDED SUBDI- VISION PLAT. UNDER NO CIRCUMSTANCES SHOULD FB FZ'.f6 ANY DATA HEREON BE USED FOR CONSTRUCTION OF FENCE LINES, OR FOR ESTABLISHING BOUND- DRAWN: ARY LINES. a-vr • "w9ft'm lk OF Ac'�`.r'S'�' i ............sp . • 0.6m M.rk Swvd • LS -6010 mOo`as� ARCTIC PUMP & WELL INC. Jim Sullivan, Cri PO Box 770197 mawEagle River, AK 99577 (907) 688-2510 (907)258-2510 (907)745-2510 am'deci net Kyle RE 22651 Gabriel Cir On 9-11-2009 We performed a well survey on this property after pulling the pump this is what we found. Total depth 143' Static 94' UN perforated casing 40'+ Harvard pit less adapter 12.5' Pump set 132.6"/. lip Pump date code 10-84 We also installed a MOA well seal and conduit. We will bill Greg at Century 21 North homes. Thanks Jim Sullivan Arctic Pump & Well, Inc. Page / of I Parcel I.D. # MUNICIPALITY OF ANCHORAGE • DEPARTMENT OF HEALTH & HUMAN SERVICES �y}i Division of Environmental Services On -Site Services Section P.O. Box 196650 Anchorage, Alaska 99519-6650 343-4744 CERTIFICATE OF HEALTH AUTHORITY APPROVAL FOR A SINGLE FAMILY DWELLING 051-811-12 HAA -Q 6f1�� 1. GENERAL INFORMATION Complete legal description Sampson Estates, Lot 7, Block 4 Section 3 Location (site address or directions) Gabriel Circle, Property owner _William Hollingsworth Day phone 688-0654 Mailing address P.O. Box 670969, Chugiak, AK 99567 Lending agency N/A Mailing address Agent Cindy/Aurora Properties Address P.O. Box 671923, Chugiak, AK 99567 Unless otherwise requested, HAA will be held for pickup. 2. NUMBER OF BEDROOMS: 3. TYPE OF WATER SUPPLY: Individual well Community well Public water 3 X Day phone Day phone 688-4939 NOTE: If community well system, provide written confirmation from State ADEC attest- ing to the legality and status of system. 4. TYPE OF WASTEWATER DISPOSAL: Individual on-site x Holding tank Community on-site Public sewer NOTE: If community wastewater system, provide written confirmation from State ADEC attesting to the legality and status of system. 72-025(Rev.1/91( Front MOA#21 5. STATEMENT OF INSPECTION BY ENGINEER As certified by my seal affixed hereto and as of the validation date shown below, I verify that my investigation of this Health Authority Approval application shows that the on-site water supply and/or wastewater disposal system is safe, functional and adequate for the number of bedrooms and type of structure indicated herein. I further verify that based on the information obtained from the Municipality of Anchorage files and from my investigation and inspection, the on-site water supply and/or wastewater disposal system is in compliance with all Municipal and State codes, ordinances, and regulations in effect on the date of this inspection. Name of Firm Eagle River Engineering Services Phone Address P.O. Box 773294 Engineer's signature River, AK 99577 6. DHHS SIGNATURE Approved fo� bedrooms. Disapproved. M Conditional approval for Additional Comments 694-5195 Date V Sell bedrooms, with the following stipulations: NuTir The Municipality of Anchorage Department of Health and Human Services (DHHS) issues Health Authority Approval Certificates based only upon the representations given in paragraph 5 above by an independent professional engineer registered in the State of Alaska. The DHHS does this as a courtesy to purchasers of homes and their lending institutions in orderto satisfy certain federal and state requirements. Employees of DHHS do not conduct inspections or analyze data before a certificate is issued. The Municipality of Anchorage is not responsible for errors or omissions in the professional engineer's work. 72-025 (Rev. 1/91) Back MOA #21 Municipality of Anchorage Department of Health & Human Services _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: l 7• el/ _V4�,�sed�j eft Parcel I.D. A. WELL DATA Well type Pr/ al - to If A, B, or C, attach ADEC letter. ADEC water system number ^J 1A Log present (Y/N) Date completed esf Driller a^'K/.) Total depth /`t°� Casedto Casing height 36 goo G��• Sanitary seal (Y/N) Date of test Static water level Well flow Pump level FROM WELL LOG SEPARATION DISTANCES FROM WELL TO: Septic/holding tank on lot `loo ' Absorption field on lot Public sewer main Sewer service line /v -)A-/a a Wires properly protected (Y/N) / v AT INSPECTION � 5 �? g.p.m. g.psjpp CO o Cl) CD CD co N On adjacent lots On adjacent lots ` Public sewer manhole/cleanout /�,4 Petroleumtank_ Wr rvh ot'��re.�t WATER SAMPLE RESULTS: Coliform 41 Nitrate D, 7 " S% Other bacteria Date of sample: 7�Collected by: Cor d YL, Ns Frr B. SEPTIC/HOLDING TANK DATA Date installed / , es- Cleanouts (Y/N) High water alarm (Y/N) N14 Date of pumping 71� ff/1 '- Tank size Z"d 5 Compartments Foundation cleanout (Y/N) Q_ Depression (Y/N) eV Alarm tested (Y/N) N Pumper ,TA S sry , SEPARATION DISTANCES FROM SEPTIC/HOLDING TANK TO: Well(s) on lot /oo On adjacent lots /ay' Foundation To property line ��� Absorption field ¢�o� Water main/service line— Surface water/drainage —4 y io 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed /9g,7 Manufacturerf�dclyc-fzgee T�,-lh Size in gallons Manhole/Access (Y/N) Y Vent (Y/N) _ y "Pump on" level at "Pump off' level at High water alarm level ', Areszt Cycles tested y Meets MOA electrical codes (Y/N) y SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot°S On adjacent lots D. ABSORPTION FIELD DATA t- /0V 7 Surface water ti Date installed 1 9 u�- 1y�� Soil rating 177 'tle f ` System type 13 Length Sy Width v Gravel thickness Totaldepth_ / eve/44,4 Total absorption area L-72 dv 'Po Cleanouts present (Y/N) Depression over field (Y/N) _ 1 Date of adequacy test _713 ya Results (pass/fail) sl for Peroxide treatment (past 12 months) (Y/N) /A If yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: bedrooms Well on lot 140 r On adjacent lots tAveo ' Property line_ y -le ' To building foundation / •7' To existing or abandoned system on lot N 14 r ate' On adjacent lots f?�' Cutbank—_ -"/" Water main/service line -V-/O ' Surface water N AA Driveway, parking/vehicle storage area _�,_A�)' Curtain drain l v"J6 ��d-re ✓�` E. ENGINEER'S CERTIFICATION I certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. Signature Engineer's Name 4DLii"r Date HAA Fee $ I 1 U, 0(� Date of Payment 2 - ) Ll -� Receipt Number o si S;) ( 351ZI 72-026 (Rev. 3/91) Back MOA 21 Waiver Fee: $ Date of Payment Receipt Number Municipality of Anchorage Department of Health & Human Services _ HEALTH AUTHORITY APPROVAL CHECKLIST Legal Description: SiSMPSOA/ &S7A 65' Parcel I.D. 051— F1 2 On adjacent lots L o7 7 /31-oCk 4 2/ / A. WELL DATA `T/5N R/k) SECT/OAl Absorption field Well type PRIV a -G If A, B, or C, attach ADEC letter. ADEC watery system number /1/.,�4 Log present (Y/N) Date completed l9i>'S �E57•i Driller 6).A/kN0W& Total depth 140 / Cased to A40 Casing height 3677 Sanitary seal (Y/N) YES Wires properly protected (Y/N) ye's M � FRO WELL LOG AT INSPECTION C o Date of test 1A 4 7/2_ y n m y � Z r Static water level Well flow -f�t- g.p.m.% g.p.m. rn -n z 69 Yc9 m f) N S Pump level UNLNOWA/ ® o U; Q SEPARATION DIST NCES M WELL TO: Septic/held+ag tan on lot /a ; On adjacent lots Absorption field on lot 00 ; On adjacent lots Public sewer main /y A ublic sewer manhole/cleanout NJ Sewer service line Petroleum tank NONL A RpAP_61,1 WATER SAMPLE RESULT Coliform ra Other bacteria Date of sample: ollected y: 0ON5%XU0,7/N6 151y6/NEEIZS B. SEPTIC/HIDLD414G TANK DATA`S Date installed ��g5 nk Cleanouts (Y/N) Foundation High water alarm (Y/N) N.A Date of pumping 7 /Z 5'/92 /DDD Compartments 7 nout (Y/N) Y65 Depression (Y/N) NO Alarm tested (Y/N)���4 Pumper SEPARATION DISTANCES FROM SEPTIC/HetEtNG TANK TO: Wells on lot O �o0 On adjacent lots '/- /001 Foundation 2/ / To property line 34 ) Absorption field f 8U Water main/service line SID Surface water/drainage M/ A 72-026 (Rev. 7/91) Front CONTINUED ON BACK PAGE C. LIFT STATION Date installed suLy /9 $`7 f%7AIV� Manufacturer _ NC J4 Size in gallons40 Manhole/Access (Y/N) _ �6 ` �/ Vent (Y/N) — /� "Pump on" level at _ !l 0 VZ " "Pump off" level at 4�/Z High water alarm level &a6NT LEV,6L Cycles tested. Meets MOA electrical codes (Y/N) es SEPARATION DISTANCE FROM LIFT STATION TO: Well on lot /0,5, On adjacent lots 'tA90` Surface water —N%A D. ABSORPTION FIELD DATA Date installed �0�87 Soil rating 11x2 018 System type SEQ Length 5 V ` Width S / Gravel thickness Total depth Total absorption area _�/�(Z[� Cleanouts present (Y/N) -YES Depression over field (Y/N) Date of adequacy test -71;?,% 9Z- d 3/,92> Results (pass/fail) _ /�i4$5 3 bedrooms Peroxide treatment (past 12 months) (Y/N) NO for NIA yes, give date SEPARATION DISTANCE FROM ABSORPTION FIELD TO: Well on lot /D D / On adjacent lots /�o Property line__ �d To building foundation % / To existing or abandoned system on lot 7" z0 � On adjacent lots 30 / Cutbank_/1,4 Water P % R/service line �U Surface water A Driveway, parking/vehicle storage area �y0 y Curtain drain NO Mt; E. ENGINEER'S CERTIFICATION l certify that I have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. / • 5 ' S O/L C'OV54 3elN6 �I-40,0Co ro L 6A4C<1ri4Cp .9.O10177491V4L /NSUc/47-leI / V' !�/2A�N�4GC. Signatureen -�` Engineer's Name���y Date _ �5z/ HAA Fee $ Waiver Fee: $ Date of Payment ��� � � 9 � Receipt Number Date of Payment �S`� Receipt Number 72-026 (Rev. 3/91) Back MOA 21 MUNICIPALITY OF ANCHORAGE DEPARTMENT OF HEALTH AND ENVIRONMENTAL PROTECTION DIVISION OF ENVIRONMENTAL HEALTH CERTIFICATE OF INSPECTION FOR HEALTH AUTHORITY APPROVAL OF ON-SITE SEWER AND WATER FACILITY `SVS 264-4720 Application Date TTTTY 14, 1987 1. GENERAL INFORMATION (a) Legal Description (include lot, block, subdivision, section, township, range) Lot 7 Block 4• SAMPSON ESTATES Location (address or directions) PETERS CREEK AK. (b) Applicant Name PAUL WELLMAN Telephone: Home NA Business 258-7890 Applicant Address PO BOX 99008 ANCHORAGE, ALASKA 99509 (c) Applicant is (check one): Lending Institutiontt; Owner/builder ❑ ; Buyer ❑ Other ❑ (explain); (d) Lending Institution ALASKA MtT[TAT BANK Telephone 258-7890 AddressP.O. BOX 99008 ANCHORAGE ALASKA -99509 - (e) Real Estate Company and Agent NA Address NA Telephone NA (f) Mail the HAA to the following address: FOR PTCKITPBY FACT T+ RATER ENGINEERING SERVICES 2. TYPE OF RESIDENCE Single-FamilyU Multi-Family ❑ Other Number of Bedrooms 3 3. WATER SUPPLY Individual Well gk Community ❑ Public ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. 4. SEWAGE DISPOSAL OnsitetF Public ❑ Community ❑ Holding Tank ❑ Note: If community well system, must have written confirmation from the State Department of Environmental Conservation attesting to the legality and status. Page 1 of 2 72-025 (1 1184) Z to Z abed -�joM s,aaau!6ue leuo!ssaload ayl ui suo!ss!wo ao saaja jol alq!suodsaj lou sl 96eaoyouy to j!led!o!unV4 9y1,panssi sl aleoilgiao a ejolaq elep azAleue ao suo!loadsui lonpuoo lou op d9H0 to saa/oldw3 *sluawaimbei alels pue lejapal welm Als!les of aapio u! suoilnipsu! 6u!pual rayl pue sawoy to s.iaseyoind of Aselinoo a se s!yl saoP d3H4 a41 'elsely to alelS a41 w P9aals!6aa Jaaul6ua leuo!ssaloid luapuadepu! up, (q anoge 9 ydea6end u1 u9A!6 suo!leluasa.idaa ayl uodn Alalos paseq saleollllaao lenoaddy Aluoylny ylleaH sanss! (d3H4) uo!loaload leluawua!Au3 pue ylleaH to luawlJedaa a6eaoyouy to Aiged!ounlN ayl T auoydalat2[3I1 USS ummamN3 2I�lm KrI a wa13 to aweN vo!loadsui s!yl to aleP a43 uo loa}la u! suo!lelnbei pue 'saoueu!pio'sapoo alelS pue led!opnln! Ile 4l!M aoue!ldwoo ui si walsAs lesods!p aaleMalseM jo/pue Alddns aaleM ails-uo ayl 'uo!loadsul pue uolleblisanul AW woal pue sapl a6eaoyouy to I!ledpunlnq ayl woal pau!elgo uo!lewiolui ayl uo paseq 1e41 Al!aaA jayunl I •u!aaay paleo!pui ainlonils to edAl pue swoojpoq to iagwnu ayl aol alenbape pue Ieuo!lounl'ales s! wags (s lesods!p aalemalseM ao/pue Alddns aalum al!s-u0 aql leyl snnoys lanaddy tluoylny ylleaH s!yl to u0!le6!isanu! Aw leyl Aj!aaA I 'Molaq uMoys alae uo!lep!IeA ayl to se pue olaaay pax!lle leas Aw (q paipliao sy NOIIVWEIOdNI (INV V1VO'HOUV3S 3-1Id `S1S31'SNO1133dSNl ONIOIAOHd Wdld 914I833NION3 -9 4 NOI1f1VO lenoaddy leu0!i!Pu00 to sw at leuo!i!puo0 Panoiddes!Q Panoaddy X. OIL d �(q swooapaq fol Panoaddy lVAO!lddV d3"0 '9 O��iy4 \� ..Ova.. pe ®o- 1561, o x 9£L9-37 - 6 a Die no •y sinol %S'° n°°amocnos.°aeo vve°ea..wrx- �i�oano vc`vveeecvevraexse,_s°bsove O�;j *)l;aS Sx.( -61B6,4-Sipe - 07 a I., vb(°�.slca,c�eeve�^R°�`'ticV L� F/ ale(] cnrc yrrtl VMA-ry 'Jr -r u f —4,1,71- ssaaPPV T auoydalat2[3I1 USS ummamN3 2I�lm KrI a wa13 to aweN vo!loadsui s!yl to aleP a43 uo loa}la u! suo!lelnbei pue 'saoueu!pio'sapoo alelS pue led!opnln! Ile 4l!M aoue!ldwoo ui si walsAs lesods!p aaleMalseM jo/pue Alddns aaleM ails-uo ayl 'uo!loadsul pue uolleblisanul AW woal pue sapl a6eaoyouy to I!ledpunlnq ayl woal pau!elgo uo!lewiolui ayl uo paseq 1e41 Al!aaA jayunl I •u!aaay paleo!pui ainlonils to edAl pue swoojpoq to iagwnu ayl aol alenbape pue Ieuo!lounl'ales s! wags (s lesods!p aalemalseM ao/pue Alddns aalum al!s-u0 aql leyl snnoys lanaddy tluoylny ylleaH s!yl to u0!le6!isanu! Aw leyl Aj!aaA I 'Molaq uMoys alae uo!lep!IeA ayl to se pue olaaay pax!lle leas Aw (q paipliao sy NOIIVWEIOdNI (INV V1VO'HOUV3S 3-1Id `S1S31'SNO1133dSNl ONIOIAOHd Wdld 914I833NION3 -9 4 SERVICES DIVISION MUNICIPALITY OF ANCHORAGE (MOA) ENVIRONMENTAL SE MUNICIPALITY ANCHORAGE EALTH AUTHORITY APPROVAL (HAA) CHECKLIST - FEBRUARY 1984 J U L 14 1987 264-4720 Legal Description: S4rY+r�sor,/ �57`~7`zwf RECEIVED gid'` 7 a/Ar- y A. WELL DATA Well Classification ��"�� If A, B, C, D.E.C. Approved (Y/N) �� Well Log Present (Y/N) Date Completed Yield 7s- Total Depth 14101 Cased to "�� Depth of Grouting Static Water Level y`/ Pump Set At Casing Height Above Ground — Electrical Wiring in Conduit (Y/N) Separation Distances from Well: Sanitary Seal on Casing (Y/N) Depression Around Wellhead (Y/N) To Septic/Holding Tank on Lot /oa ; On Adjoining Lots fioJ To Nearest Edge of Absorption Field on Lot 100 ; On Adjoining Lots To Nearest Public Sewer Line l/ To Nearest Public Sewer Cleanout/Manhole '% To Nearest Sewer Service Line on Lot 7'_a J_ Water Sample Collected by F�5,1^16-- ; Date 57/8 7 Water Sample Test Results o- (:�v /.'�" j N, tr< fic — O. 741 me /Z - Comments B. SEPTIC/HOLDING TANK DATA A.1 Date Installed /9&S_ Size- 1G�4 / No. of Compartments 42 Standpipes (Y/N) ,Y Air -tight Caps (Y/N) Y Foundation Cleanout (Y/N) �y Depression over Tank (Y/N) N Date Last Pumped Pumping/Maintenance Contract on File (Y/N) ; for Holding Tank High -Water Alarm (Y/N) ��G Temporary Holding Tank Permit (Y/N) Separation Distances from Septic/Holding Tank: To Water -Supply Well /00 To Building Foundation To Property Line -3`f (' off `3e-^t�'�� To Disposal Field 96 '211 To Water Main/Service Line To Stream, Pond, Lake, or Major Drainage Course Comments Page 1 of 2 72-026(11/84) �1 C. ABSORPTION FIELD DATA Soils Rating in Absorption Strata 7��� Type of System Desigr Date Installed /yS7. ,Ta f� —� Length of Field Sd Width of Field Depth of Field r..0. Gravel Bed Thickness Square Feet of Absorption Area /dO ` Standpipes Present (Y/N) Depression over Field (Y/N) /V Date of Last Adequacy Testes - ��-✓sh Eng Results of Last Adequacy Test Separation Distance from Absorption Field: To Water -Supply Well add 11 To Building Foundation 4ot f a o 67' To Property Line -flo 4 ; On Adjoining Lots To Existing or Abandoned System on f 30' To Water Main/Service Line To Cutbank (if present) ti/y To Stream/Pond/Lake/or Major Drainage Course To Driveway, Parking Area, or Vehicle Storage Area '7VF Comments .4 e ,�X A, e, f1/ e.+ i YY. y r T�,✓y D. LIFT STATION Date Installed Dimensions J` �c� o .. lei11 Size in Gallons - 0 Manhole/Access (Y/N) "Pump On" Level at "Pump Off' Level at High Water Alarm Level at �resst z--eX Vent (Y/N) Tested for . (.vewl Pumping Cycles during Adequacy Test. Meets MOA Electrical Codes (Y/N) L lcewcA--i /-' le- E74:ge, ✓ rP ,%,ick 71/ Comments Awc-/. Te, ore -714- 46 l.><> Srg �.�.. /rlcr r,�.�,.r 2e4Y-�,.ew ,r ** Check Permitted Bedroom Rating Against HAA Request ** I certify that II have checked, verified, or conformed to all MOA and HAA guidelines in effect on the date of this inspection. SignedDate Company MOA No. ! aeS- Receipt No. - —Q —0 G /7 Date of Payment Amount: $ �bo Page 2 of 2 Eagle River Engineering Services P. 0. Box 773294 Eagle River, AK 99577 72-028 (11/84) 691-5195 RA